
LIBRARY OF CONGRESS. 



Chap. Copyright No. 

Shelf_.„SX5 U\ 

« \j 3 y> 

UNITED STATES OF AMERICA. 




DISEASES OF THE SKIN. 



DISEASES OF THE SKIN : 

Their Constitutional Nature 
and Cure. 



BY 



J. COMPTON BURNETT, M. ID., 

f i 

AUTHOR OF 
11 RINGWORM : ITS CONSTITUTIONAL NATURE AND CURE." 



Si nonjuvat, mode ne noceat. 

By their fruits ye shall know them. 



Third Edition, Revised and Enlarged, 



PHILADELPHIA : 
BOKRICKK & TAFKL. 

T Ml 01898 

1898. 



7970 






Copyrighted 
^ BY 

BOERICKK & TAFEL. 



5 bl 



T. B. & H. B. COCHRAN, 

PRINTERS, 

LANCASTER, PA. 



PREFACE TO THIRD EDITION. 



T^OR this third edition, I have added 
Part Third, dealing with the cure 
of alopecia areata by constitutional remedies 
without any local applications whatever. 
And it seems to me that if the disease can 
be cured by the exhibition of constitu- 
tional remedies in purely dynamic dose, 
the said disease must itself be of a con- 
stitutional quality, as the nature of the 
curative means indicates the nature of 
the malady. 

J. COMPTON BURNETT. 

86 Wimpoi^e Street, Cavendish Square, 
London, W., 

Christmas 1897. 



PREFACE TO SECOND EDITION. 



'T^HIS present edition I have very con- 
siderably enlarged by adding Part 
Skcond, consisting more particularly of 
Cases illustrating the Constitutional Cure 
of Diseases of the Skin, and this has ne- 
cessitated an alteration in the title of the 
work. Almost every day brings me evi- 
dence confirmatory of my views of the 
nature of constitutional skin diseases, and 
I am increasingly impressed with the dire 
results that accrue to those sufferers there- 
from whose cutaneous manifestations 
have been got rid of by lotions and oint- 
ments. 

London, W. 

Midsummer iSpj. 



PREFACE TO FIRST EDITION. 



TN the following pages I take largely 
-*- the clinical standpoint, and consider 
the Diseases of the Skin constitu- 
tionally. The treatment of skin diseases 
as merely local affairs concerning the skin 
only, as is now current with nearly all 
medical men of all schools and all the 
world over, is, in my opinion, nothing 
less than a crime against humanity, and 
eminently characteristic of the cultured 
shallowness of the medical profession of 
to-day. 

In "these days of 'scopes and meters," 
thinking, in the profession, is w 7 ell-nigh 
dead. One sees no end of percussing and 
auscultating : the faintest murmurs, 
sounds, tinkles, rales and bruits are well 
known and learnedly discoursed of, but 
what of the curi?ig ? w T hat of the real 
aetiology of the Consumptive process 
itself? Bacilli. Yes, but what went on 
before bacillary life became possible? and 



x Preface. 

how are the bacilli to thrive unless the 
soil be, for them, of the right kind? 

I do not maintain that there is no such 
a thing as a skin disease of a purely local 
nature, such as common phtheiriasis and 
other parasitic dirt- diseases that impinge 
upon the skin, but, speaking generally, I 
do maintain the following points : — 

i. That the skin is a very important 
living organ of the body. 

2. That it stands in intimate, though 
ill-understood, relationship to all the in- 
ternal organs and parts. 

3. That its healthiness is conditioned 
by the general healthiness of the organ- 
ism, — i. e. y a healthy skin on an un- 
healthy body is inconceivable. 

4. That, speaking generally, its un- 
healthiness — its diseases — come from 
within, sometimes even when they 
initially impinge upon it from without. 

5. That being biologically within the 
organism, being fed from within, having 
its life from within, having its health 

from within, and having its diseases from 



Preface. xi 



within, it must also be treated medicinally 
from within, 

6. That skin diseases are most com- 
monly not merely organic, but at the 
same time organismic, or constitutional. 

7. That the skin being an excretory 
organ, and being spread out all over the 
organism, is often made use of by Nature 
to keep the internal organs free from 
disease. 

8. That as each portion of the skin cor- 
responds vitally with some internal organ 
or part, so the skin disease is often merely 
the outward expression of internal disease. 

9. That, in fine, the generally received 
external treatment of Diseases of the Skin, 
whether with lotions or ointments or 
whatsoever else, is demonstrably shallow 
in conception, wrong in theory, harmful 
in practice, and therefore inadvisable. 

These points embody my views on 
Diseases of the Skin ; they guide me in 
my practice, and I might call upon the 
dermatologists to refute them, did I not 
hold them to be absolutely irrefutable. 



xii Preface. 

If disease of the body bubbles up, so to 
speak, into the skin like water from a 
spring, to treat this Disease in (of) the 
skin by washes and ointments, or other 
outward applications, is really not treat- 
ing the diseased state at all, but only pre- 
venting its peripheral expression. 

The skin does not live an independent 
life of itself — hung on, as it were, outside 
of us — but is of all our organs the most 
systemic ; but what can we expect from 
an age in which people think they get a 
beautiful healthy skin from soap, and 
sound teeth from tooth-powder ? 

The bark of a tree is a very fair ana- 
logue of the skin, and when I one day 
asked my gardener why the bark of a 
certain apple tree was so knobby, rough, 
and unhealthy- looking, he replied, "The 
roots have got down on the clay, Sir." 

So it is, I opine, when a person's skin 
becomes diseased. " The roots have got 
down on the clay." 

London, September, 1886. 



DISEASES OF THE SKIN. 



PART I. 



Angina Pectoris from Sup- 
pressed Skin Disease. 

ONE Sunday morning, some ten 
years ago, a gentleman ushered 
His wife into my consulting-room 
because she had been taken with 
an attack of angina pectoris in the 
street, on her way to church. 
Though only a little over thirty 
years of age, if so much, she had 
been subject to these attacks of 

B 



Diseases of 



breast-pang for several years : 
they would take her suddenly in 
the street, nailing her, as it were, 
to the spot, and hence she no 
longer went out of doors alone, 
lest she should faint away or fall 
down dead, as was apprehended. 

An examination of the heart re- 
vealed no organic lesion, or even 
functional derangement, and I could 
not quite see why a comparatively 
young lady should get such anginal 
attacks. She had been under able 
men for her angina, but it got no 
better, and no one could apparently 
understand it. I prescribed for her, 
and saw her subsequently at her 
home, to try and elucidate the 
matter. I let her tell me her whole 
health-story from her earliest 



the Skin. 



childhood. She said she was get- 
ting to the end of her teens, and 
was preparing to come out, but she 
had some cracks in the bends of 
her arms that were very unsightly ; 
these cracks in her skin had 
troubled her from her earliest 
childhood. Erasmus Wilson was 
consulted ; he gave her an oint- 
ment which very soon cured her 
skin, and the patient came out 
socially, made a hit right off, and 
got married in due course. She 
had always felt very grateful to 
Erasmus Wilson for curing her 
arms, for otherwise, u How could 
I have appeared in short 
sleeves." 

But there soon followed dyspep- 



Diseases of 



sia, flatulence, dyspnoea, and pal- 
pitation, and finally the before- 
described attacks of angina pectoris 
threatened to wreck her life. More- 
over, she had borne one dead 
child. As I have already said, 
there was no discoverable cardiac 
lesion, and from the lady's health- 
history I gathered that this cure of 
her skin (though to me the one im- 
portant point) was of no casual 
importance. 

I gave my opinion that her skin 
disease had never been really cured, 
only driven in by Wilson's oint- 
ment, and that her angina was in 
reality its internal expression or 
metastasis. No one believed it, how- 
ever. I began to treat her anti- 



the Skin, 



psorically, and very soon — I think 
it was less than a month from the 
Sunday morning visit — the old 
cracks reappeared in the bends of 
the elbows, and from that time on 
she had no further attacks of angina 
at all, and thenceforth she bore 
living children. 

Specific Enexanthematic 
Asthma. 

Not long after the before-men- 
tioned experience I was consulted 
by a Liverpool gentleman for 
asthma of a very severe type. He 
was somewhere near forty, and had 
the appearance of a very old man, 
partly from the habitual bent posi- 
tion, from his shortness of breath, 
and partly from loss of sleep and 



Diseases of 



much physicking. About a third 
of his life was spent in these attacks 
of asthma. In listening to his life- 
history, I noticed that he dated his 
asthma to a cold caught during a 
child's disease with a cutaneous 
eruption, and also, judging from 
his subjective symptoms, I con- 
cluded that he was suffering from 
an enexanthema, an internal skin 
disease of a specific nature. I 
treated him nearly a year on this 
hypothesis, and he got a strange 
coppery condition of the skin, which 
peeled off almost all over his body, 
much of his hair falling out at the 
same time. He was forthwith free 
of his asthma, and never had it 
again during the two following 
years, at the end of which period I 



the Skin, 



lost sight of Him. His skin be- 
came quite healthy, and his hair 
grew again. 

Asthma, Psoriasis, and En- 
larged Liver. 

A gentleman of thirty came un- 
der my care some years since, suf- 
fering from asthma, enlargement 
of the liver, psoriasis, and eczema. 
When his skin was very bad, his 
breathing was well ; and conversely 
if his skin got well, he was almost 
sure to get an attack of asthma, 
particularly in certain places. I 
treated his liver and his skin for 
many months — in fact, for nearly 
three years. It is now nearly two 
years since he had any attack of 
asthma, and he is well of both skin 



8 Diseases of 

and liver, though sun and wind 
still affect his skin unduly. 

Hydrocephalus, Eczema, La- 
tent Vaccinosis. 

• 

In the early part of the year 
1885 I was requested to see the 
only surviving child of a country 
clergyman, who had been given up 
by three medical men, as it had 
water on the brain. The child's 
head was of the usual hydrocepha- 
lic type ; he was alternately wake- 
ful and delirious at night, and he 
talked nonsense by day at intervals. 
Their local doctors had taken a con- 
sultant's opinion, and they agreed 
that the boy was suffering from 
tuberculosis of the meninges with 
effusion, of which a little brother 



the Skin, 



had previously died. The child's 
life-history was told to me, and I 
underlined the facts that he had 
had eczema, and had been twice un- 
successfully vaccinated. After the 
^successful vaccinations (want 
of organismic reactionary power) 
the eczema almost disappeared, 
and very soon the present disease 
began. I treated the case thus 
causally ex-hypothesi ; a severe pus- 
tular eruption, and then patches of 
lepra and eczema appeared, and at 
the end of about six months' treat- 
ment I was able to discharge the 
little patient, cured of his water on 
the brain and of his skin diseases. 
I saw him the other day, and 
learned that he continues well and 
has grown a good deal. 



io Diseases of 



Eczema Capitis Suppressed — 
Fatal Issue. 

About nine years ago the wife of 
a staff-officer brought her bonny 
little baby to me : it had the milk- 
crusty scalp, so horrible to aesthetic 
mothers — in fact, it had crusta 
lactea, or eczema capitis. The scalp 
appeared one solid crust of scabs, 
but the child seemed perfectly well 
and jolly. I prescribed for the 
child constitutionally, and forbade 
all local treatment. The lady's 
father, however, was a retired phy- 
sician of repute, and he went to 
stay at the daughter's house. See- 
ing the grandchild's eczema, he 
told the mother to use an ointment 
to the scalp. She told her father 



the Skin. n 

of my warning not to put anything 
on the bad head, but the old gentle- 
man over-ruled it, and prescribed 
unguentum zinci, which soon 
healed the eczema. About a fort- 
night later I was suddenly sum- 
moned by telegram to see the child: 
it had been taken with convulsions 
from effusion on the brain, and the 
local doctors were already non- 
plussed. I did my best to get the 
eczema back on the surface of the 
scalp, but totally failed ; the child 
died, and the grandfather sobbingly 
cried, " Oh ! that zinc ointment." 

Double Cataract from 
Suppressed Eruption. 

A Middlesex grocer brought his 
bright little boy of six or seven to 



12 Diseases of 

me about two years since : the boy 
had double cataract, and was quite 
blind. Said the father to me : He 
used to have an eruption on his 
head, but that was cured by the 

doctors at the Hospital for 

Diseases of the Skin. And soon 
after he was cured of his eruption 
we noticed his sight was failing — 
before that his sight was all right. 

Eczema, Ophthalmia. 

A lady of fifty came under my 
care in October 1879. Two years 
previously she had had eczema of 
the vulva,with much nocturnal irri- 
tation. Dr. W. cured it with bran 
water and vegetal diet. In August 
1879 she got eczema behind the 
right ear, when her physician gave 



the Skin. 13 



her Graphite 3^ and Merc. sol. 3* in 
alternation. 

In September of the same year 

she went to A , and there met 

a doctor, who gave her a saline 
draught, and an ointment con- 
taining zinc, lead, and mercury, 
to be applied at night. 

This cured the eczema. She 
came to me for an inflammation of 
right eye, that came very soon 
after the eczema was cured. I ex- 
plained to her that the ophthalmia 
and the eczema were really the 
same thing, and advised constitu- 
tional treatment, to which she con- 
sented. She was worse at the 
sea-side, she was constipated, her 
skin was dry, salt beef caused con- 



14 Diseases of 

stipation and faintness, and she 
was low-spirited. Natrum muria- 
ticum, 6 trit., and other remedies, 
cured her constitutionally, and she 
had not had any return of skin 
disease or ophthalmia, when her 
husband called on me, on June 2nd, 
1885, or more than five years 
thereafter. 

Ossified Heart from Sup- 
pressed Eczema. 

In the year 1874, 1 was attending 
a country squire for eczema of the 
whole body of a very bad type, — in 
fact I never saw a worse case. He 
could not undress without laying 
a sheet on the carpet, as the quan- 
tity of dried scabs that fell off was 
really considerable : after undress- 



the Skin. 15 



ing lie was in the habit of using the 
coal-shovel to shovel them up. I 
treated him to the best of my 
ability for a long time, but in vain ; 
he grew rather worse than better. 
I called in a consultant of very 
great experience and world-wide 
reputation, and we treated the case 
together ; but the eczema defied 
us, and so did the patient too. He 
sent for me one day, said he was sick 
of the weary, weary " constitutional 
treatment " of which I was always 
telling him. I solemnly warned 
him against local measures, such 
as baths and ointments, saying : 
" Remember this, Mr. , I ac- 
knowledge that I have quite failed 
to cure your eczema with my 'con- 
stitutional treatment,' at which it 



1 6 Diseases of 

pleases you to poke fun, but you 
yourself never enjoyed better health 
in your life, although your eczema 
is indeed almost as bad as ever. 
You are disgusted with your foul 
disease, and you mean to be rid of 
its outward expression, come what 
may. I am sorry for you." 

He went to an eminent special 
skin doctor, now deceased, and in 
a few months was cured of his 
eczema by means of ointments, 
washes, and mineral waters. 

For four years I did not see him, 
and then he called to consult me 
about difficulty oj breathing "that had 
been slowly creeping on for several 
years, — in fact was firstfelt not long 
after his being cured by Mr. S. of 
eczema I should have said that 



the Skin. 17 



the patient in question told his skin 
doctor of my warnings anent his 
eczema, and this gentleman made 
light of it, declaring that it was my 
incompetence to cure that deserved 
attention, and used such language 
about me professionally that my 
patient would not allow my name 
to be mentioned in his house for 
nearly three years. Then his dys- 
pnoea became a serious matter, 
and his physicians all failed to cure 
it, though they all declared that 
his lungs were sound. At last he 
found that an extra glass of cham- 
pagne, a tiny incline, the gentlest 
game of croquet, all upset his 
breathing, and the doctors' skill 
failing, too, he went to the South 
of France, and to spas, and then 



1 8 Diseases of 

to lung specialists, but all to no 
purpose — his breathing slowly and 
surely grew worse. Finally he 
came to me, "to please his wife." 
He seemed quite well to look at; 
there was no trace of his former 
eczema on his skin; his lungs were 
all right,but his heart was irregular 
in its action, and there was neither 
apex-beat nor radial pulse. No 
medicines did him any real or per- 
manent good, though many well- 
chosen remedies relieved his vari- 
ous symptoms; in fact, I cured 
all his symptoms over and over 
again, and then he died of his 
disease. We had a post-mortem ex- 
amination of the body, and found 
ossification of the heart in about 
two-thirds of its extent, with os- 



the Skin. 19 



seous and quasi-osseous adhesions 
to the diaphragm, and shrinking 
of the liver. 

No doubt, to my mind, about 
the genesis of the degeneration 
of the internal organs. When 
Nature was prevented from speak- 
ing as eczema by Mr. S.'s skin- 
gagging, she used the internal parts 
wherein to deposit the irritant 
material which produced inflamma- 
tion and ossification of the most 
vital organ — the heart — rendering 
a continuation of its functions im- 
possible. Such are the facts, and 
such my reading thereof. 

In these pages I rely purposely on 
my own observations exclusively, 
but the following excerpt from the 



20 Diseases of 

very orthodox Record is so con- 
sonant with my views, that I here 
interpolate it : — 

Disappearance of Psoriasis and 
Trachoma after Erysipelas. 

Striking instances of internal 
affections being cured by some 
outward, or other, acute manifes- 
tation constantly recur in medical 
literature. A few years since I was 
reading in the London Medical 
Record (April 15, 1886, p. 155, et 
seq.), that — 

" Dr. Porfiry G. Bazaroff, of Belyi 
Klutch, records {Proceedings of the 
Caucasian Medical Society, No. 18, 
1885, p. 433) the case of a highly 
scrofulous soldier, aged 22, who 
was admitted with general psoriasis 



the Skin. 21 



vulgaris of two years' duration, 
severe trachoma of long standing 
on both sides, and enlargement of 
the cervical and submaxillary 
glands. The treatment failing to 
relieve any of the patient's ex- 
tremely obstinate and troublesome 
affections, the regimental snrgeons 
resolved upon placing him on the 
roll of ' unfit for service.' Abont 
that time, however, the patient was 
suddenly attacked by erysipelas of 
the face and head. There was 
nothing peculiar either in the 
course or in the treatment of the 
disease. The erysipelas disappeared 
in seven days> and with it the trach- 
oma, the glandular swellings and 
psoriasis (first of the face, then — 
after two hot baths — of the remain- 
3 



22 Diseases of 

ing parts) also disappeared, leaving 
no trace. ' In fact, in a week an 
"unfit" became quite a healthy 
man/ the author adds. Dr. Bazaroff 
mentions, also, a rather obscure 
case of a young soldier, who had suf- 
fered from daily and nightly in- 
continence of urine, of two months' 
duration, and who got rid of the 
symptoms after an attack of ery- 
sipelas of the face and head. In 
another patient, a boy, aged 22 
months, with congenital hydro- 
cephalus of the progressive kind, a 
mild attack of scarlatina was fol- 
lowed by a steady diminution in the 
bulk of the head (in a month the 
large circumf erencelessened a centi- 
metre, the minor 3), an improve- 
ment in his general state, &c. Two 



the Skin. 23 



months later, however, the child died 
from general convulsions. [Dr. M. 
Tiimpovsky recently published a 
case of disappearance of ascites from 
erysipelas (see the London Medical 
Record, May, 1885, p. 19,). Dr. K. 
Koltchevsky saw a case of trachoma 
cured by erysipelas {lb., July, p. 
296). Dr. Mishtolt's patient was 
cured by the same disease from 
sarcoma {lb., January, 1884, p. 
11). In the Vratch, Nos. 38-41, 
1882, Dr. F.J. Pasternatzky, of Pro- 
fessor J. T. Tchudnovsky's clinic, 
details two cases of the disappear- 
ance of hepatic ascites under the 
influence of typhus fever, and a case 
of renal dropsy cured by relapsing 
fever. In the St. Petersburg Med. 
Wochensch., No. 43, 1883, Dr. 



24 Diseases of 



Schmidt published a case where 
erysipelas of the chest had caused 
a rapid disappearance of an enor- 
mous pleuritic exudation — Rep^] " 
All this surely proves that topic 
disease is not local, but organic and 
organismic. 

Eczema with Internal Meta- 
static Symptoms. 

A few years since — May, 1886 — 
I met with a very striking example 
of the intimate connection that ex- 
ists between a skin affliction and 
internal symptoms. I had seen the 
lady in town and prescribed for her 
on April 13th, 1886, and I re- 
ceived the following letter, sub- 
sequently. I give it just as I 
received it, and will let it tell its 



the Skin. 25 



own simple though instructive 
tale — 

" A few days after I came to see 
you I was very unwell — at the 
usual time— which commenced four 
days too soon, and lasted nine days. 
On the fourth day, Sunday, April 
1 8th, I was taken at 5 A. M. with 
fainting, &c, as before; took brandy 
just in time to prevent going quite 
off. This was followed by sickness, 
alternate heat and chill, and I was 
unable to take any food without 
causing sickness ; I was so ill that 
my brother became anxious, and 
sent for the nearest homoeopathic 
doctor. The sickness continued 
frequently until he arrived about 
1 P. M. I was very weak and in 
my room for some days. 



26 Diseases of 

" During this time the eruption 
on hands and face disappeared, and 
the cracks healed, but as soon as I 
recovered it broke out again and 
was worse than ever on my face, 
large patches of spots continually 
running, with heat and irritation. 
Both face and hands were much 
swollen, and the eruption extended 
to wrists and neck — right side of 
neck below the ear being swollen 
and tender. 

"After a few days the fingers and 
backs of hand became very badly 
cracked ; for ten days I could 
scarcely use my hands, and they 
are still very sore ; there is less 
tendency to heal than usual, and 
considerable irritation ; the joints 
of fingers are also swollen." 



the Skin. 27 



This lady had previously had 
catalepsy on various occasions, and 
she consulted, me for the neurosis 
principally. 

Eruption on Scalp— Cataract. 

The following case is very in- 
structive, as showing the nature of 
a skin affection of the head (scalp), 
and its power of expressing itself 
in the lens if compelled to retire 
from the outer integument. 

Towards the end of the year 
1880, a boy of four was brought to 
me from the South of England. 
His sight was good until he was 
about two years old, when he had 
incipient cataract in the right eye, 
then in the left one, and at the age 
of three he was blind. 



28 Diseases of 



I elicited the following note- 
worthy anamnestic point : He used 
to have great irritation of the skin 
ever since he was a few months 
old ; when between eight and nine 
months old he was treated for it 
with " sulphur ointment, a lotion, 
and medicines. " 

After the first medicine which I 
ordered him an eruption came 
on his skin, and more particularly 
on the scalp, and he began to 
see ! His mother reported that he 
altered in his gait, for whereas he 
formerly looked straight out before 
him fixedly at the light, now he 
bends forward. He further as- 
tonished his parents by remarking 
that there was a certain colour in 



the Skin. 29 



the painted ceiling, pale green. 
There was also slight bnt evident 
change in the opaque lenses them- 
selves. 

Now, although I had given to 
the parents, as my opinion, that 
the cataract was a direct conse- 
quence of the cured (suppressed) 
skin affection from which the child 
had suffered, still, no sooner did my 
medicine begin to bring back the 
eruption to the scalp than the 
mother forthwith applied some zinc 
ointment she had in the house! 
The zinc ointment did its w r ork 
very promptly and effectually ; the 
eruption disappeared, and so did 
the returning vision, — i. e. } the boy 
went quite blind again, and re- 



30 Diseases of 

mained so. He also began to talk, 
laugh, and cry in his sleep again 
as he had previously done 

The further course of this case 
showed most conclusively that the 
opacity of the lenses, and the scalp 
eruption, stood in causal nexus, — 
that is to say, they had a common 
cause. Orthodox medicine cured 
the eruption with ointment, then 
came the cataract, which is again 
cured by operation. Truly, we 
live in an age of wisdom and en- 
lightenment. 

Vaccinal Dermatitis. 

Although I hold that vaccina- 
tion, in due dose, protects, on the 
homoeoprophylactic principle, from 
small-pox, still it is nevertheless a 



the Skin. 31 



fruitful source of skin diseases. I 
may be allowed to transcribe a few 
cases from my little treatise, en- 
titled " Vaccinosis and its Cure by 
Thuja, with Remarks on Homceo- 
prophylaxis " (London and New 
York, 1884), which illustrate this 
point, viz. : — 

Pustular Eruption. 

Mr. J , a hale-looking, middle- 
aged London merchant, came under 
my observation on November 3rd, 
1881. Said he, " I am not a 
homoeopath, but twenty years ago 
I had eczema, and the allopaths 
could not touch it, so I went to a 
homoeopathic doctor, and he cured 
me." And he went on to say that 
he believed in homoeopathy for 



32 Diseases of 



skin diseases. On the left leg lie 
had a pustnlar eruption, due, he 
believed, to a bruise. He had 
also eczema of the ear, and he 
volunteered the information that 
ever since his second vaccination 
he had been subject to eczema. 
The eczema of twenty years ago 
was soon after the re-vaccination. 

Jfy Thujcz Occidentalis 30. Four 
three-drop powders to the two 
dozen. To take one, dry on the 
tongue, three times a day. 

He came in a week nearly well ; 
the pustules had at once begun to 
wither. 

The Thuja was repeated, but in 
less frequent doses, and the patient 
subsequently sent word by his 
brother to say that his skin was 



the Skin. 33 



well, and he himself too busy to 
show himself as he had promised. 

Pustular Eruptions. 

Miss , aet. 18, was re-vaccin- 
ated in July, 1881, at her parents' 
country residence, thirty miles from 
London, by the local surgeon, with 
"lymph" direct from the calf. The 
operation was very succcessful, and 
she had a very " fine " arm. But 
as the u arin" was just at its greatest 
perfection she got an eruption on 
her chin, covering its whole extent 
and involving the lower lip. The 
thing was very unsightly, and had 
a singularly ugly, repulsive aspect. 
The gentleman who had done the 
re-vaccinatian was of opinion that 
Miss had got some of the vac- 



34 Diseases of 

cine virus on to her finger-nails and 
inoculated herself by scratching. 
The sequel, however, showed that 
the chin manifestation was from 
within. The surgeon had ordered 
applications, two of which were 
vaseline and zinc ointment, but the 
eruption on the chin was not to be 
got rid of. The young lady had to 
wear a dense veil to hide her face 
when driving out. She was brought 
to London for my advice, and I 
gave Thuja 30 In a fortnight she 
was out and about, and only some 
diffused redness of the skin re- 
mained, but no scar or thickened 
skin. Now, it might be objected to 
this case that the Thuja had noth- 
ing to do with the disappearance 
of the eruption, because it was just 



the Skin, 35 



the history of the disease : it ran 
through its natural course and died. 
I thought that to myself at the time 
of prescribing it ; but against this 
was the fact that the arm had healed 
already, and it had passed the 
natural course of vaccinia by at 
least a fortnight when I first pre- 
scribed the Thuja. But to have a 
test, I gave her brother, who also 
had a somewhat similar pustular 
eruption (and who had been re-vac- 
cinated at the same time) , but more 
spare, and instead of being on the 
chin, it was around the left nostril, 
I say, to have a test, I gave this 

brother of Miss Antimonium 

tart., which is also, as every one 
knows, apparently homoeopathic to 
such a pustular eruption. 



36 Diseases of 

This is the brother of Miss 

(observ. w.) 

The two eruptions were similar, 
though the boy's was comparatively 
trivial, and of the same age, and 
from the same cause, z. e m} from the 
vaccine virus. The patients went 
into the country, and in two or three 
weeks' time the mother wrote that 
the young lady was quite well : 
"the medicine soon put her right," 
was her expression, but the boy had 
" a bad cold in his head ; nose-bleed; 
left side of nose swelled and red ; 
two little spots of matter, the size 
of a large pin's head, at the edge of 
the nostril, and below it, having 

something the look of 's chin; 

his arm is also not well, and he has 
had four little pocks about the vac. 



the Skin. 37 



cination marks." I sent Thuja 30, 
and he was reported well in ten days. 
If any one can account for the 
cure of these two cases independ- 
ently of the Thuja, his ingenuity is 
greater than mine. That they were 
causally connected with the re-vac- 
cination admits of no doubt what- 
ever. 

Hairless Patches ox Chin. 

Mr. , a London merchant, 

came under my care on July 27th, 
1882, to be treated for some 
roundish hairless patches on either 
side of his chin, which began four 
months ago. The larger patch on 
the right side was about the size 
of a florin. Had also an old horde- 
olum on his right lower eyelid. 
4 



38 Diseases of 

Has been twice vaccinnated ; the 
second time, twelve years ago, did 
not " take." 

Jfy Thuja Occidentalis 30 (4 in 
24). To take one, dry on the 
tongne, at bedtime. 

Sept. yth. — The bald patches are 
smaller, the one on the left side 
nearly gone. Has, apparently, a 
very bad coryza — (?) organismic 
reaction. 

Rep. 

Oct. lyth. — The bald patches are 
gone; the old hordeolnm also gone. 

The closely-shaven beard is now 
uniform, the previously-existing 
white bald patches being com- 
pletely covered with hair. 

I give this as an interesting cure 



the Skin. 39 



by Thuja, but I am not very sure 
that the disease was really due to 
vaccinosis, because of other points 
in his clinical history. Still it might 
have been so, as the hair is very 
powerfully influenced by the vac- 
cine poisoning. Thus Kunkel ob- 
served both a very weak growth of 
hair and an excessive growth, es- 
pecially in wrong places, as effects, 
he believed, of vaccination. There- 
fore, let it stand as a doubtful case 
of vaccinosis for what it may be 
worth, — but there can hardly be 
any reasonable doubt as to the cure 
of the case by Thuja. 

Here it might not be amiss to 
observe casually that the presence 
of sties on the eyelids is often, in 
my opinion, a symptom of vaccino- 



40 Diseases of 

sis. This case is not without prac- 
tical importance, inasmuch as ho- 
diernal medicine hands over a sty 
to the chirurgeon's art ; and all the 
time, poor old dame, weens herself 
so very much superior to scientific 
therapeutics usually called homoeo- 
pathy. The conceit of the ortho- 
doxly ignorant is truly sickening. 

Acne of Face and Nose, and 
Nasal Dermatitis. 

A young lady,about twenty years 
of age, was brought by her mother 
to me on October 28th, 1882. 
Patient had a very red pimply nose, 
not like the red nose of the elderly 
bibber, or like that due to dyspepsia 
or to tight-lacing, but a pimply, 



the Skin. 41 



scaly nasal dermatitis, which ex- 
tended from the cutaneous covering 
of the nose to that of the cheeks, 
but appearing more as facial acne. 
The nasal dermatitis was, roughly, 
in the form of a saddle. Of course 
this state of things in an otherwise 
pretty girl of twenty was painfully 
and humiliatingly unpleasant to 
her and to her friends, — in fact, it 
was likely to mar her future pros- 
pects very materially, more espe- 
cially as it had already existed for 
six years and was making no signs 
of departing. She also complained 
of obstinate constipation. The 
pimples of the nose and face used 
to get little white mattery heads. 
In trying to trace the skin-affection 
back to its real origin I ascertained 



42 Diseases of 



that the patient was re-vaccinated 
six years ago, but she could not 
remember whether the nose was 
previously affected or not. This 
re-vaccination was unsuccessful, t. 
e., it did not u take." 

Jfy Thuja Occidentalis 30. 

Nbvember 30th. — Pimples of face 
decidedly better. Nose less red. 
Constipation no better. 

]J Thuja Occidentalis 100. 

January ^rd } 1883. — The face 
is free ! Her mother gratefully 
exclaims, " She is wonderfully 
better." I ask the young lady 
which powders did her most good ; 
she says, "The last." The skin of 
the nose is normal, but the consti- 
pation is no better, and for this she 
remains under treatment. 



the Skin. 43 



That Thuja cured this case is 
incontrovertible ; but that it was a 
case of vaccinosis is not quite so 
certain, though it is far from im- 
probable. The re-vaccination and 
inflammation of the skin of the nose 
were referred both to six years ago 
when she was in Switzerland at 
school ; but patient could not 
remember which was first — the bad 
nose or the vaccination. 

Diseased Finger-nails. 

On December 22nd, 1882, a 
young lady of twenty-six came 
under my care for an ugly state of 
the nails of her fingers. Naturally 
a lady of her age would not be 
indifferent to the state of her nails. 



44 Diseases of 



These nails are indented rather 
deeply, and in addition to these 
indentations there are black patches 
on the under surfaces of the nails, 
reaching into the quick. Very 
slight leucorrhoea occasionally. 
She had chicken-pox as a child of 
eleven. On her shoulders there is 
an eruption of roundish patches 
forming mattery heads. Has been 
vaccinated three different times ; 
the last time two years ago, and the 
nails have become diseased since 
this last vaccination. The black 
patches have existed these eighteen 
months. 

Looking upon this diseased con- 
dition of the nails as evidence of 
chronic vaccinosis, I ordered her 
Thuja 30 (one in 6) . 



the Skin. 45 



March iqth, 1883. — Has . con- 
tinued the Thuja 30 for just about 
three months, with the result that 
within a fortnight from commencing 
with it the black patches under the 
nails began to disappear, and there 
is now no trace of them. The 
indentations are notably better. 
The eruption on the back has not 
been modified, and for this she 
remains under treatment ; but I 
thought this much of a case of nail 
disease would be of some interest, 
and the more so as it is not easy 
to demonstrate drug-action on nail 
growth at all. 

The foregoing cases sufficiently 
exemplify the causalnexus existing, 
as I believe, between vaccination 



46 Diseases of 

and diseases of the skin. However, 
by no means must be attributed all 
skin affections, following closely 
or remotely in the wake of vac- 
cination, to the pathogenetic effect 
of the vaccine virus itself; it does 
cause numerous skin diseases with- 
out a doubt, but it also, and 
frequently, rouses latent disease for 
which anti-vaccinial treatment will, 
of course, not suffice. 

Ringworm of Scalp — Cataract, 

At the beginning of 1883. a boy 
of six was brought to me, from 
Yorkshire, with opacities of both 
lenses. The failing of his sight 
was first noticed in 1881. Had 
been under an oculist of repute, who 



the Skin. 47 



had given some drops to be put 
into the eyes, but these drops 
could not be used after the first 
instillation, as they u made the 
child like a dead'un for days." 
Has been delicate all his life, and 
notably worse since the measles in 
the summer of 1880. 

Had ringworm of the scalp in 
the summer of 1879, which was 
cured by internal (probably tonic) 
and external treatment. The father 
says he is u wick/' which he ex- 
plains means lively. After four 
months of Sulphur 30, and then of 
the 200th, this report came — " My 
boy is still improving with his eyes 
slowly; they have not that large, 
glaring appearance ; look more 
natural, and he has not been 



48 Diseases of 

excited in his sleep ; I think his 
head is cooler. " 

A little later I received a letter 
to say that the boy had " ringworm 
on his scalp again!" That was the 
last I heard of him. 

The connection of cataract and 
various skin affections has long 
been noticed and written about by 
numerous authors, but the doctrine 
is not accepted by many. On this 
point I take the liberty of referring 
to my treatise on Cataract,* which, 
through the kindness of my learned 
friend, Dr. Goullon, of Weimar, has 
lately been translated into German. 
From it I quote the following, 
bearing thereon (pp. 47, 48). 

* " Curability of Cataract with Medi- 
cines." London and New York, 1880. 



the Skin. 49 



Scabies— Cataract— Furuncles. 

Young man, set. 20, had had the 
itch one year and a half ago, of 
which he got rid by internal and 
external use of medicines. Later, 
he had an attack of intermittent 
fever, which he cured with pepper 
and whisky. A short time since 
he discovered that he could not see 
with his left eye. The eye had a 
dead look ; pupil was enlarged and 
immovable; in the middle of the 
lens there was an opacity, as if it 
had been punctured by a needle ; 
the lids and conjunctiva were some- 
what reddened. On holding the 
hand quite near to the eye he could 
dimly discern the fingers. August 
2, Sulphur 6 ; August 9, SEVERAL 



50 Diseases of 

PIMPLES ON THE FACE AND ARMS. 

Sight better. Sulph. 6, which was 
repeated on the 19th, 26th, and 
29th of August, and on the 3rd 
and 23rd of September. There 

APPEARED A NUMBER OF FURUNCLES 

on THE arms ; theeyelooks natural 
again, and he sees as well as ever 
before. — (Fr. Emmerich, " Arch." 
XIV., iii., p. 105. In Raue.) 

And then (pp. 7-78)— 

Dr. Bernard gives an epitome 
of fifteen cases from Riickert's 
Klinische Erfahrungen. 

I will only give the fifteenth at 
this place. 

Crusta Lactea. 

The fifteenth is this: Crusta lactea 
disappears and cataract supervenes, 



the Skin. 51 



which latter is cured with Spirit 
Sulph. (Autore, Schcenfeld) . 

Dr. Bernard also notes that in 
several of the cases habitual perspir- 
ation s re-appear, or a cutaneous erup- 
tion either appears or re-appears. 

Need we any further proof that 
cataract is a cutaneous affection ? 

Tetters. 

Dr. Becker treated a carpenter 
who had been affected for some time 
with tetters about the face, which 
disappeared after a while without 
his taking any medicine, but his 
sight became impaired, everything 
appeared in a place different from 
its real position, so that he was 
unable to use his tools properly. 

The pupils presented a misty, 



52 Diseases of 



smoky appearance, as in the form- 
ing stage of cataract. He received 
Sp. Sulph., ten drops three times a 
day ; the old eruption re-appeared, 
and he now saw everything in the 
right position, but otherwise his 
sight was not improved. 

Then on March 22nd, Aq. Silic. 
was administered in doses of seven 
drops daily, and this was followed 
by a great improvement in his sight. 
He perspired easily, and had much 
perspiration about the feet. Deposit 
in urine like lime. 

July, — A rheumatic inflamma- 
tion of the foot set in. 

Suppressed Perspiration of 
Feet. 

The same gentleman treated a 
lady whose feet generally perspired 



the Skin. 53 



freely and then became very dry, 
and thereafter she noticed that her 
sight became affected in snch a 
manner that everything she looked 
at appeared to be enveloped in a 
cloud; she could only read large 
print. 

Aq. Silic. was administered in 
doses of ten drops twice a day. 
The accustomed perspiration of the 
feet returned again in about a 
month. Her eyesight became much 
better. Two months latter, at the 
time of menstruation, her eyes be- 
came worse again, and she then 
took twenty drops Ac. Silic. three 
times a day, after which she im- 
proved very much, could read bet- 
ter, and continued taking the same 
remedy. 
5 



54 Diseases of 

Scabies — Ague. 

(Pp. 98, 99, 100)— 

M., aged 20, tinsmith by trade, 
was affected a year and a half ago 
with the worst kind of itch, and 
subsequently with fever and ague. 
Sometimes he had tearing pains 
in the left eye, and some itching 
of the skin, to which he paid very 
little attention; suddenly he noticed, 
however, that he had become com- 
pletely blind in the left eye. 

Symptoms. — A staring look of 
the left eye ; pupil dilated and im- 
movable ; in the centre of the lens 
there was slight opacity ; his sight 
was almost extinguished. 

Ti'eatment. — August 2. — Sulph. 
6 ; from August 9th to September 
23rd, six doses of the same. 



the Skin. 55 



Six days after the first dose, many 
pustules appeared on the face and 
arms ; in the meanwhile his eye- 
sight improved so much that he 
was enabled to distinguish large 
letters. From September 13th to 
September 23rd, furuncles on the 
arm made their appearance ; after 
that the skin became clear again, 
and the affected eye was as useful 
as it had ever been before. — 
("Arch." XIV., v., p. 105. Em- 
merich.) 

Of the connection of the skin and 
the lens embryologically and patho- 
logically I will say no more, merely 
referring those interested in the 
subject for further information to 
" Curability of Cataract." 



56 Diseases of 



The " Sternal Patch." 

One often meets with liver 
affections connected with cutane- 
ous manifestations. 

I would like particularly to refer 
to a patch of eruption on the skin 
covering the lower part of the 
sternum, which I have several 
times found co-exist with heart 
disease and swelling of the left 
lobe of the liver. In my case-tak- 
ings I call it the " sternal patch." 

I have four such cases in my 
mind at this moment. The first I 
will narrate is that of a mayor of 
a large town in the north : — He 
had a patch of brownish lichen on 
the sternal portion of thorax, of 
the size of a woman's palm; with it 



the Skin. 57 



were associated an enlarged liver 
and a cardiac affection, evidenced 
by palpitation, systolic murmur, 
and general uneasiness. He came 
to town to see me at odd intervals 
for about two years, and was then 
discharged cured. I treated him 
antipsorically and organopathic- 
ally, the most notable benefit be- 
ing derived from Carauus Maricz in 
five drop doses of the strong tinc- 
ture given three times a day. 

The second, I remember, was a 
Manchester merchant, with the 
same kind of cutaneous patch on 
the sternum, and very notable 
heart trouble, with arcus senilis as 
a concomitant. Here the ease and 
comfort brought by the Carduus 
Maricz were very striking. Under 



58 Diseases of 

date of January 31st, 1883, 1 & n & 
in my case-book these words of 
the enthusiastic patient, — " It had 
a most marvellous effect; soon 
made me right; the patch went 
away in a fortnight; had had it 
for years." 

This gentleman has remained 
under my care, calling upon me at 
odd times when in town, and 
during the past two years has 
had, besides the strong tincture 
of Carduus, Bellzs perennis 1, 
Aurum metallicum 4, Vanadium 
6, and Acidum oxaltcum 3*, and 
some other remedies, and I con- 
sider him vastly improved, and 
his life — speaking commercially— r 
worth 40 per cent, more than 
previously. 



the Skin. 59 



The third case was that of a 
New York merchant, who suffered 
from liver, and had pome over to 
Europe to consult a physician, as 
he seemed to get no better from 
the treatment of his New York 
advisers. I found his liver very 
much enlarged, and also the 
before-mentioned sternal patch of 
skin disease. I gave him Car duns 
in like dose to the foregoing, and 
he came in a week declaring him- 
self quite well. I advised him to 
remain awhile under observation, 
to see if the cure proved per- 
manent, but he hurried out of my 
room in great glee, and I never 
saw him again. 

The fourth case in which I found 
the sternal patch and enlarged 



60 Diseases of 

liver, giddiness, and palpitations of 
the heart, was that of a London 
lawyer. Here the liver got well, 
and the heart too, together with 
the giddiness, but it needed a 
course of antipsoric treatment to 
finish the cure of the patch of 
diseased skin. I might say the 
same of a fifth case, — an officer in 
the Royal Navy, where this patch 
co-exists with hypertrophied liver, 
and in which the affair has a 
specific air about it, probably in- 
herited. 

Sarcognomy. 

I foretell that, in the future, 
when the relations of the various 
cutaneous regions will be recog- 
nised as constituting the very base 



the Skin. 6 1 



of medical and medicinal diagnosis, 
this sternal patch will be under- 
stood to indicate " liver and heart." 

Chin and Throat Affections. 

At the commencement of 1873 
a young lady came from a distance 
to consult me in regard to her 
throat. She told me she had 
originally relaxed sore throat, and 

went to Mr. , who cauterized 

it a good many times, and she 
used gargles and other local means 
on his advice. Her throat became 
better, but she then got a series 
of quinsies. Then came recom- 
mendations of changes of air 
and tonics. She had thereafter 
nothing to complain of in her 
throat, but her chin had become 



62 Diseases of 

the seat of some nasty spots. For 
these she returned to the same 
gentleman, who cured the chin 
with ointment. After her chin got 
well her throat again troubled her. 
Renewed cauterizings ; throat 
again cured. Then the face and 
chin were covered with spots and 
pimples afresh. So she went on 
for six years under the most many- 
sided surgeon of the day, who writes 
so very philosophically about the 
pedigree of disease, but who treats 
his patients generally locally all the 
same, absolutely unmindful of the 
twaddling dictum about " gleams 
of a fruitful suggestion. " Well, as 
this young lady's chin and throat 
persisted in playing hide and seek, 
she felt constrained to try something 



the Skin, 63 



else. I went into the case care- 
fully, and found that the real seat 
of the constitutional disturbances 
giving rise to the symptoms 
in the throat and on the chin 
was neither in the throat nor in the 
chin, but in the ovaries, and so, of 
course, the silly treating of the 
throat and chin had led to nothing. 

The Absurdity of Specialism. 

Probably it would not be easy 
to obtain a more striking example 
of the absurdity and futility of 
ordinary local treatment usual with 
most of the so-called specialists 
than this : — 

Miss Nora , twenty-four 

years of age, was brought to me in 
June 1885, that I might give my 



64 Diseases of 

opinion of her case. My treatment 
was not sought at that time. 
Twelve years previously she had 
scarlet fever, and following thereon, 
measles. Ever since then she has 
been deaf. She has been subject 
to hay fever these twelve years, and 
also bronchitis. Her father has 
hay fever, and also one of her 
brothers. She is also subject to 
a very severe form of nettle-rash; 
at her menstruation she suffers 
" excruciating agony," and the 
discharge is very profuse and very 
clotted ; very bad leucorrhoea. 

The treatment she had was at 
first that of their ordinary (homoeo- 
pathic) family physician, who, fail- 
ing to relieve the dysmenorrhoea, 
took her to a gynaecologist of great 



the Skin. 65 



reputation, who performed an opera- 
tion, but it did no good at all. 
She then was treated by the family 
doctor for her bronchitis. Then, 
she was sent away for her health 
for varying periods and to various 
places. 

Now she is actually under two 
specialists ; one treats the ear, 
and the other is treating her hay 
fever. In addition to these two 
learned brethren, her mother is also 
treating her " nettle-rash' ' with 
domestic homoeopathy. 

With all this local tinkering 
and pottering and domestic mess- 
ing, she is no better. No one has 
attempted to take a view of her 
entire economy as a living unity. 
Is it any wonder that all these fruit- 



66 Diseases of 



less measures have made the poor 
girl almost bewildered ? 

Relationship of Skin Affec- 
tions to Internal Organs. 

As illustrating the general na- 
ture of skin affections, and their in- 
timate relationship with other or- 
gans and parts, I will narrate a 
part of the history of a lady of rank, 
now forty odd years of age. 

Originally, some fifteen or more 
years ago, she had badly ulcerated 
legs, and her local surgeon cured 
them quickly with an ointment. 
Soon after this cure — of which 
both patient and doctor were very 
proud — she had ulcers on the 
eyes, which a late eminent oculist 
cauterized, without being able to 



the Skin. 67 



get rid of them ; then a very noted 
London physician saw her, and 
said he thought the ulcers on the 
eyes were due to the too rapid 
cure of the ulcerated skin of the 
legs, and ordered her to use 
vinegar compresses over her shins, 
with the object of inducing fresh 
ulcers ; but, at the same time, he 
ordered her to use golden oint- 
ment to the eye ulcers, — which 
golden salve forthwith cured them. 
The vinegar compresses produced 
an eruption on the legs, as they will 
on most people. 

How this unctuous physician 
could give an opinion that the eye 
affection arose from the quasi-cured 
leg ulcers, and then forthwith order 
an ointment to cure th? eye ulcers 



68 Diseases of 

on precisely the same lines, might 
at first sight seem strange, only 
one knows of him that he mistakes 
a jumble of second-hand clinical 
tips for laws of therapeutics. 

Presently the poor patient found 
that getting rid of corneal and con- 
junctival ulcers with golden oint- 
ment was anything but a cure of 
the disease essentially, for the next 
step of the progress of the disease 
was in the eye, not on it. The 
inside of the eye not lending itself 
to unctuous handling, it was sought 
out with the — knife ! The operation 
had to be repeated several times. 
Well, it's a long, weary story, and 
patient is nearly blind, and almost 
eyeless these several years. 

I was listening to this history 



the Skin. 69 



two days ago, and the poor lady 
exclaimed, u Ah! if I had but 
never used that golden ointment." 

Eczema — Enlarged Ovary — 
Chronic Oophoritis. 

It is about two years since a 
lady of forty came from a distance 
to see me ; she was an invalid, 
and had not had a month of good 
health for many years. I found her 
suffering from chronic oophoritis of 
the right side, which recrudesced 
every month at the menstrual 
time, and which was often accom- 
panied by circumscribed peritonitis. 
The ovary was enlarged to about 
the size of an orange, was very 
tender, and was clearly attached 
by post-inflammatory adhesions 



jo Diseases of 

to the peritoneum. The dysmenor- 
rhoea was very terrible, and the 
periodical peritonitis was quite an 
illness. She had leucorrhoea, and 
her visage told the tale of great 
and repeated sufferings. Treat- 
ment has quite cured her, and she 
now leads an active, useful life ; but 
that is not the point I wish to dwell 
upon, but rather upon its origin. 
I found from her history that 
she used to suffer from eczema ; 
she went to Erasmus Wilson, who 
prescribed " zinc ointment and 
other things/' and quickly cured 
it (the eczema). Patient herself 
denied "ever having had anything 
the matter with her skin ;" it was 
her relations who told me of the 
old eczema. 



the Skin. 71 



People have certain preconceived 
ideas of diseases : if they know you 
are suffering from " liver," they 
smile ; if you have anything wrong 
with your brain, rendering you 
insane or vicious, they are afraid 
of you and lock you up in an 
asylum ; if you have anything 
wrong with your skin, they shun 
and despise you, little weening 
that the same or a like morbid 
essentiality may be at the bottom 
of them all. And hence, when 
questioned about their " skin," 
people not infrequently stop short 
of all the truth. 

Constitutional Nature of 

IvUPUS. 

It is very curious that even 
where some eminent and thought- 



7 2 Diseases of 

ful dermatologists admit the con- 
stitutional nature of a given skin 
disease, they still adhere to the 
local treatment. For instance, it 
is now thought and taught by 
some advanced men that lupus is 
a tuberculous disease of a bacil- 
lary nature. 

As giving the latest views on 
the pathology of lupus — the most 
terrible of all skin diseases — I 
should like to quote freely from 
Dr. Walter G. Smith's paper in 
the February (1885) number of 
the " Dublin Journal of Medical 
Science.' ' 

Professor Smith says : — 
" Turning now to the pathology 
of lupus, we find two chief views 
prevailing as to its aetiology — 



the Skin. 73 



"1. What may be termed the 
Anglo-French school, — z. e., that 
lupus has a constitutional founda- 
tion, and is allied especially to 
scrofula. 

"Mr. Jonathan Hutchinson 
seeks, with Auspitz, to widen the 
signification of lupus, and contends 
for a clinical l lupus family' of affec- 
tions. He regards lupus on th e whole 
'as a sort of cross produced by ten- 
dencies at once to scrofula and can- 
cer, while it receives many modifi- 
cations, from peculiarities in the 
patient's skin and his morbid ten- 
dencies , in one or the oth er direction . ' 
It is interesting to note that a similar 
view was put forward as novel at the 
time by Dr. James Houghton, fifty 
years ago: — 'Were we called on 



74 Diseases of 

to declare our opinion of the essen- 
tial character of lupus, we should 
say that it is an intermediate patho- 
logical state between cancer and 
scrofula, partaking somewhat of the 
nature of both, but constituting a 
state in which, by the blending of 
these two diseases, many of their 
peculiar characteristics are lost.' 

" 2. The Vienna school, as repre- 
sented by Kaposi, — that lupus is an 
exclusively local affection, and 
hence constitutional treatment is 
rejected as useless. But notwith- 
standing Kaposi and the arguments 
he adduces, converging evidence has 
been accumulating in favor of the 
doctrine that lupus is a branch of 
the tuberculous stock ; or in other 
words, that lupus will find its true 



the Skin. 75 



place among the chronic infective 
diseases of the skin, — i. e. } those 
dependent upon the action of an 
organised virus capable of repro- 
ducing itself in the body (e. g., 
lepra, syphilis, and tuberculosis). 

" The following remarks refer 
particularly to lupus vulgaris, for 
the nature of lupus erythematosus 
is still a matter of controversy, and 
Veiel places it among the super- 
ficial inflammations of the skin 
along with eczema and impetigo. 

11 The question, then, is this — 
Syphilis has a specific virus, like- 
wise leprosy and tuberculosis ; is it 
so with lupus ? 

"Ziegler, while he places lupus 
among the infective granulomata, 
admits that ( the exciting cause of 



76 Diseases of 

lupus is unknown.' Similarly Hyde 
— l The causes of lupus vulgaris 
are absolutely unknown ;' and 
Neisser, in his admirable article, to 
which I am largely indebted, and in 
which he upholds on general patho- 
logical grounds the tuberculous 
nature of lupus, says : — ' But I can- 
not yet adduce the exact proof 
of this connection, since neither I 
nor others have hitherto succeeded 
in demonstrating with certainty the 
bacilli of tuberculosis in lupous 
material.' He presently adds that 
he holds the forthcoming proof to 
be only a question of time. 

" The question may be con- 
veniently studied from three points 
of view — viz., clinical, histological, 
and experimental. 



the Skin. 77 

" 1 . Clinical Aspects. — Upon this 
point suffice it to say that while 
Kaposi and his followers are unable 
to see any connection with scrofula 
or tubercle, andeven ridiculethe pro- 
position, they have arrayed against 
them the testimony of numerous 
skilled observers in England, 
France, and Germany, who recog- 
nize the points of resemblance, and 
note the frequent coincidence of 
cheesy affections of the glands, 
bones, and joints with lupus. I can- 
not give statistics from my own 
cases, but certainly the association 
of lupus with scrofulous glands is 
sufficiently common here, and with 
Fagge and others, I have witnessed 
the development of lupus secondary 
to suppurative strumous inflamma- 
tion. 



78 Diseases of 

" Now, since the fundamental 
unity of scrofulosis and tuberculosis 
has been established both on clinical 
and experimental grounds, if it can 
be shown that an intimate relation 
exists between lupus and scrofula, 
an argument will be furnished for 
bringing lupus into the tuberculous 
family. M. Besnier, one of the 
foremost French dermatologists, in- 
sists upon the connection between 
lupus and tuberculosis. In June 
and July 1883, among 38 patients 
under his care for lupusin St. Louis, 
8 presented well-marked physical 
signs of phthisis. Dr. Tilbury Fox 
states that lupus, in many cases, 
occurs in phthisical subjects ; and 
Mr. Hutchinson has pointed out 
that phthisis is not unfrequently 



the Skin. 79 



observed in the families of those 
suffering from lupus. 

u It is quite true that lupus is 
rarely observed in several members 
of the same family (Fagge) , that it 
is seldom found in combination 
with general tuberculosis, and that 
we have no evidence of hereditary 
or of direct transmission in the 
human subject. 

" 2. Histological '.-Careful investi- 
gations have shown that no essen- 
tial difference can be established be- 
tween a caseating miliary tubercle 
and a lupous nodule, which some- 
times exhibits ' the exact appear- 
ance of tubercles ' (Ziegler). The 
pathological processes in each are 
the same in kind, but differ in 



8o Diseases of 

degree. Thus in lupus it is less 
acute and less intense, and hence 
we get slower development of the 
inflammatory granuloma with a 
richer development of vessels, and 
consequently a more gradual de- 
struction towards the centre, with 
peripheral healing and formation 
of spindle cell-tissue, — t. e. } cicatrix 
(Neisser). But the decisive proof 
— the demonstration of tubercle- 
bacilli in lupus material — remained 
to be given, and it was not long 
before Neisser's prophecy was ful- 
filled Dr. Robert Koch, follow- 
ing up Friedlander's anatomical 
investigations, examined seven 
cases of lupus of unimpeachable 
diagnosis. 

" In 4 cases he excised parts of 



the Skin. 81 



the skin. In 3 cases lie examined 
scrapings only of the lnpons tissue. 

" For direct microscopic investi- 
gation lie used only the excised 
bits of skin. The tubercle-bacilli 
were found sparsely in each of the 
4 cases, and only in the interior of 
the giant-cells. The tubercle-bacilli 
in lupous tissue are so isolated that 
in 2 cases the bacilli were not found 
until in the one case 27 sections, 
and in the other 43 sections had 
been made. Yet it repeatedly 
happened that when in a number 
of sections not a single bacillus 
appeared, sections taken close by 
exhibited one to three bacilli. 
Koch never found more than one 
bacillus in a giant-cell. 

" According to Unna, the bacilli 



82 Diseases of 

are observable in quantity by par- 
tially digesting Hardened speci- 
mens, and examining the precipitate 
that falls down. Demme, Pfeiffer, 
and Doutrelepont had published 
records of the occurrence of tuber- 
cle-bacilli in lupous skin, and in 
the tubercles of animals inoculated 
with lupus. But Koch states that 
his experiments were finished for 
some months before their com- 
munications were published. 

"The curiously sparse occurrence 
of the bacilli in lupus suggests a 
ready explanation of some of the 
negativeresultsofotherhistologists, 
and likewise forbids the hope of 
deriving material help in diagnosis 
from the use of the microscope. 
So far as I am aware, bacilli have 



the Skin. 83 



not been demonstrated in connec- 
tion with lupus erythematosus. 

" 3. Experimental. — Koch made 
inoculations from all his seven cases 
into the anterior chamber of the 
eyes of rabbits. In every case this 
was followed by tuberculosis of the 
iris, and in those animals which 
lived long enough, by general tu- 
berculosis. Numerous tubercle- 
bacilli were found in these inocula- 
tion-tubercles. From one specimen 
(excised from the cheek of a boy ten 
years old) he obtained pure cultures, 
which were several times utilized for 
successful inoculations on animals. 

11 Again, Pagenstecher made three 
inoculations from conjunctival 
lupus into the anterior chamber of 



84 Diseases of 

the eyes of rabbits. In two cases he 
succeeded ; in one he failed. Micro- 
scopical examination of the two suc- 
cessful cases by PfeifFer (Ehrlich's 
method) exhibited Koch's bacilli, 
duly recognized as such by Ziegler, 
Ehrlich, and others. Positive re- 
sults such as these, coupled with 
those of Schiiller and Hiitter, more 
than counterbalance the negative 
results announced by Cohnheim, 
Hansel, and others. 

" Two years ago Vidal and Leloir 
could assert that ' no results have 
been obtained from the experimen- 
tal inoculation of animals with lu- 
pus.' Gathering together, then, the 
foregoing evidence, we seem to be 
guided to the conclusion that lupus 
is a tuberculosis (scrofulosis) of the 



the Skin, 85 



skin excited by the tubercle-bacil- 
lus. The localization of the bacillus 
in the skin, and the relatively rare 
involvement of other organs, con- 
stitute the peculiar features of 
lupus as compared with other forms 
of tuberculosis. The bacilli of 
lupus and tubercle are probably the 
same qualitatively, but there is a 
quantitative difference which is ac- 
centuated by the more unfavorable 
conditions of nutrition in the colder 
skin. Complications with tuber- 
culous affections of other organs — 
e. g., glands, joints, bones, and 
even with analogous skin affections 
— e.g., ulcerating scrofuloides, are 
frequent. Their non-occurrence 
does not contradict the tuberculous 
aetiology of lupus. 
7 



86 Diseases of the Skin. 

" Genetically, then, there is only 
one tnbercnlosis of the skin, and 
we may say that while lupus is 
always tuberculosis of the skin, yet 
tuberculosis of the skin assumes 
other forms than that of lupus 
(Neisser) . 

" In short, the evidence is strong 
of the unity of cause in tuberculo- 
sis, lupus, and scrofulosis, although 
we do not yet know the special 
determining conditions of each case. 
Ewald even goes so far as to sug- 
gest Morbus Kochii as a clinical 
term for this group of three, by 
way of analogy to Morbus Brightii, 
but this innovation is scarcely like- 
ly to be approved. The subjoined 
table may be useful for reference:— 





^t^ 






(T> * £ 






vj rD £ 


$ 




P> P 


s 




E: o rt> 




^2£ 


3 






3-. 


> 


rt^3 

O • P 


55 


cr 


Q O 




0> 


£ C£ 




»~t 


-t £ 




■t 


rD c/i 




p 






3 






r-f 






o 


J- 1 ft" 1 




5 

pa 


Q rD *e 


s 1 




P rt C 


« 

3 




lgari; 
rans, 
ligna 


3-. 






§ 






r^ 




P> £ p 

o 2, 
55" r> 



P 

rD 
p 



p 

ts- 
cr 

rD 

g. 

r? 1 

P 

p 
P^ 



Q 



Co 





r+ O W 




° P "< K> 




o 


!. Lupus 
der 
A harm 
stem) fo 
losis, m 
the skin. 


d 

c 


O 
P 
CD 


2i 3 ^ 1 C: 

r_+ P c/> & *S 


p 


IT) 


»— * ^^ > 




tub 
imit 






rD ™ Si • 
P* ? ^ 





c+- 


p 


p XX' 


V* 


»t 


cr 


tJ 




p o 


o 


-OQ <s>. 




ften yields 
tment. 


ro 
in 


fro 
cold 


<*> 




o 

c/> rD 

ere % 


rating 
derma. 


2* 




ons 
stin 
uta: 


\ 




P Crq 
o> w p 


% 






o 


8 


r-t- 




p o So* 


^ 


o 




C/> »-+> i 


i 



w 

O 

d 
f 
o 

co 

I— I 
CO 

O 

w 
w 

CO 



88 Diseases of 

" If asked for a definition of 
lupus, I would say it is l a very 
chronic new cell-growth, depending 
upon infection with the bacillus 
tuberculosis, always ending by 
scars, with or without ulceration, 
and usually developing brownish- 
red nodules.' " 

Now, one would naturally say 
that if the aetiology of lupus be, 
as Dr. Smith avers, really to be 
referred to the same bacillus as 
that of miliary tuberculosis, then it 
must be simply a local affection, 
and the disease would be cured by 
external local treatment. And 
Dr. Smith is true to this view, 
for he says, " It will be generally 
admitted that local treatment is 



the Skin. 89 



the more important. "" But this 
is not my experience, for I have 
never seen a single case of lupus 
really cured by local treatment, 
though I have sometimes seen the 
morbid process stopped by very 
severe cautery or excision ; though 
even these severe measures com- 
monly fail completely. 

It is very difficult to cure lupus 
by internal medications, but it can 
be done ; and Dr. Smith himself 
quotes Dr. J. Warburton Begbie 
as mentioning that many years 
ago, when a student in Paris, he 
saw numerous cases of ulcerating 
lupus in the wards of St. Louis' 
Hospital, which were materially 
benefited, and some apparently 
cured, by the administration of 



90 Diseases of 



cod-liver oil in very large doses, 
and that Dr. Todd Thomson was 
extremely successful in temporar- 
ily, and sometimes even perma- 
nently, arresting the ravages of 
lupus, — undoubted improvement 
following the use of certain rem- 
edies, " chiefly iodine, iron and 
arsenic conjointly, while local ap- 
plications were sparingly used." 
Although Dr. Smith believes 
lupus to be dependent upon the 
tuberculosis bacilli, still he says :- — 
u . . . On the whole, in reference 
to the internal medication of lupus, 
we cannot maintain that as yet we 
know of any specific against the 
lupus [i. e., tuberculosis) virus; and 
perhaps the most that can be done 
in this way is by strengthening the 



the Skin. 91 



constitution to increase the capa- 
city for resistance of the body 
against the spread of the germs of 
the disease. " 

We see the Professor is slightly 
befogged in his notions as soon as 
he touches the art of curing ! 

Tout comme les autres ! 

Now, either lupus is, or is not, 
due to the same bacillus as tuber- 
culosis ; and if so, what relation 
does the lupus-bacillus bear to the 
lupus-virus ? or are we to consider 
bacillus and virus the same thing ? 

If lupus is ever to be cured it 
must be cured by internal medica- 
tion in some direct way by a medi- 
cament, or by medicaments, stand- 
ing in some relationship to the whole 
lupus process ; to pretend to cure 



92 Diseases of 

it by killing the bacilli is like the 
grand old way of catching sparrows 
by putting salt on their tails. 

Case of Generalized Favus. 

If there be any one disease of 
the skin more than another to 
which one might accord the quality 
of being local and external, it is 
certainly Favus ; and yet I read 
in the London Medical Record 
under the heading of " Case of 
Generalized Favus" (August 15, 
1885), that— 

" Professor Kaposi ( Wien. Medi- 
zin. Presse, Oct. 26, 1884) exhibited 
at the Medical Society of Vienna a 
remarkable case of favus in which 
the disease was present on many 
parts of the skin. 



the Skin. 93 



u The patient having died of 
phlegmonous inflammation of the 
popliteal space, the autopsy was 
made by Professor Kundrat, who 
found that there was favus of the 
stomach. Intheneighbourhoodofthe 
pylorus there was a patch of infil- 
tration about the size of a 2 -franc 
piece, covered with necrosed tissue 
2 millimetres thick. In the exuda- 
tion, spores and mycelium were 
found analogous to those present on 
the skin. It was not found in the 
intestine. The fungus appears to 
have provoked the disease of the 
stomach. The man had been a 
drunkard, and it is probable that 
the acidity of the gastric juice was 
sufficiently diminished to admit of 
the fungus developing, — an expla- 



94 Diseases of 

nation which, however, Professor 
Bamberger refused to admit." 

In this case it would have been 
eminently instructive if Professor 
Kaposi (who treats almost every 
skin disease as a local affection) 
had given the treatment of the 
defunct Favus-bearer. That the 
treatment was local is almost cer- 
tain. Moreover, one very naturally 
asks, of what nature was the in- 
flammation of the contents of the 
popliteal space ? 

Tumours and thk Skin. 

An eminently instructive case 
came under my observation on 
August 13, 1885. A lady, just over 
50 years of age, came to consult 
me with regard to a tumour in her 



the Skin. 95 



right breast, I having successfully 
treated a lady friend of hers for a 
similar affection. But it is not 
about this tumour, as such, that I 
wish to speak, — it is the antece- 
dent constitutional condition of the 
patient that bears on my present 
thesis, viz., the systemic nature 
of skin diseases. Well, this lady 
had suffered from red angry 
pimples on her face, chin, chest, 
and back all her menstrual life, 
with coincident neuralgia of right 
ovary. She had in vain used 
washes, ointments, and baths for 
the skin ; only temporary ease and 
amelioration resulted. But about 
a year before the date of her visit, 
she fell with her right breast 
against a bedstead, and a few 



96 Diseases of 

months later she noticed a hard 
lump in her right breast, and her 
family physician, with a consultant, 
urged immediate operation, to 
avoid which she came to me. Just 
as postscripts are said to contain the 
real r arson d^etre of a given epistle, 
so the parting observation of a 
patient often throws a strong light 
on a case. And so here. As she 
rose from her chair to go, she said, 
" ... It is very funny, doctor, but 
my skin has been so much clearer 
since the lump came, — in fact, I 
have very few pimples now ; I dare 
say that has nothing to do with it, 
but I thought I'd just mention it." 
Precisely. 

If I have in the foregoing pages 



the Skin. 97 



succeeded in showing that diseases 
of the skin are really diseases of 
the system, though on the skin, 
then my task is accomplished. In 
the near future I hope we may have 
some definite conception of the 
correspondences that undoubtedly 
exist between certain regions of the 
body surface and the internal 
organs, independently of general 
organismic interdependence, and 
then we shall, perhaps, be able to 
see why certain cutaneous diseases 
affect certain parts preferentially, 
and also why, when these diseases 
are driven in whence they came, 
by external means, certain inter- 
nal organs have to bear the brunt 
of it. 



98 Diseases of 



Fletcher's "Etiology." 

In his "Elements of General 
Pathology," p. 99, this great 
thinker says, in regard to the eti- 
ology of skin diseases, " Certain 
other peculiarities of diet, as the 
use of cream, cheese, honey, 
cucumbers, the kernels of fruits, 
etc., are a frequent exciting cause, 
according to the idiosyncrasy of 
the individual, of urticaria, lepra, 
pityriasis, pomphylix, and other 
cutaneous eruptions, all which 
seem to rise in these cases from 
sympathy with the stomach ; and it 
is thus that psoriasis, acne, etc., 
result from cold drinks taken when 
the stomach is hot." 

So that, at least in such cases as 



the Skin. 99 



Fletcher cites, if the treatment is 
to be local, in what condition is 
the stomach left ? and which is the 
locus morbi, the stomach or the 
skin? 

I am myself very much disposed 
to regard what Fletcher calls cl the 
idiosyncrasy of the individual " as 
a pathic idiosyncrasy such as, for 
example, exists in those persons 
who are subject to hay fever. 

Acne from Cold Drinks. 

In this little volume, I am, before 
all things, seeking to show that 
Diseases of the Skin have, for the 
most part, their origin, not in the 
skin itself, but are essentially cu- 
taneous manifestations of some 



i Co Diseases of 



more or less remote organic or or- 
ganismic wrongs. 

Thus Fletcher mentions Acne 
from Cold Drinks, and anent this I 
wish here to quote an interesting 
and instructive experience of my 
own of the curative effects of the 
common Daisy in complaints that 
are due to wet cold — e. g n acne of 
the face. 

As I consider the observation of 
wider practical importance, I will 
give the source of my own knowl- 
edge. 

Bellis PerEnnis against the 

Ill-Effects of Wet Cold in the 

Overheated. 

I refer to " D. Johann Schroe- 
der's Pharmacopoeia Universalis " 



the Skin. 101 



(with Hoffmann's Remarks) ,Niirn- 
berg, 1748. The Daisy is here 
commended in Haemorrhage, Dys- 
entery, as a " herrliches Wund 
kraut : ," internally and externally,— 
i. e., as a vnlnerary, — for the effects 
of falls, blows, bruises and the like, 
pains in the joints, rheumatism 
(and hence called " Gicht kraut "), 
in nocturnal cramps, angina pec- 
toris, fevers and inflammations ; for 
lameness; and he says that German 
mothers were in the habit of using 
it for their children as an aperient. 
An ordinary commendation of 
Arnica reads almost in the same 
terms, but what I would specially 
call attention to is this — " This 
herb is useful to such as have 
partaken of a too cold draught of 
8 



102 Diseases of 

something, for it possesses a 
peculiar quality, as shown by ex- 
perience, of being useful in all those 
terrible and dangerous accidents 
that arise from having drunk 
something very cold when the body 
is in a heated condition." This 
important point I have verified, as 
will be seen later on. 

Further, it would appear that 
Mindererus, inhis Kriegs-Artzeney, 
cannot sufficiently praise the Daisy 
in such cases, for he declares that 
an account of this action of the 
herb should be written up over all 
gates and doors for the benefit of the 
poor harvesters who in the hot har- 
vest season get ill from partaking 
of cold drink ; its effect in such 
cases he affirms is remarkable, and 



the Skin. 103 



so prompt that amelioration sets 
in at once. 

Christoph Schorer, in his Me- 
dicina peregrinantium, gives simi- 
lar testimony, and says that he 
cured two men of dangerous coughs, 
with emaciation, that were due to 
their having drunk something cold 
when they were heated. And 
Schroeder affirms that it will cure 
dropsy due to drinking too much 
in " dog days," — i. e., hot weather. 

We know from experience the 
immense value of certain generali- 
zations in the treatment of dis- 
ease, as, for instance, Arnica for 
falls and bruises; Hypericum for 
wounded nerve tissue ; Dulcamara 
for the ill effects of damp, and so 
on. 



104 Diseases of 

Now we may add this other, that 
Bellis perennis is a curative of com- 
plaints due to drinking cold drinks 
when the body is heated, — 1\ e., 

EFFECTS OF SUDDEN CHILL 
FROM WET COLD WHEN ONE IS 
HOT. 

Of the use of Bellis for the ill 
effects of cold water suddenly 
brought into contact with a heated 
body, I offer the following instruc- 
tive Case. I will call it 

Habitual Periodical Facial 
Dermatitis. 

Miss P., aet. 30, came under 
my observation on September 
24th, 1879, and gave the following 
history : — Ever since she was 1 2 
years old she had been subject to 



the Skin. 105 



an eruption of great bumps in the 
face about every three weeks, some- 
times less, sometimes more; at 
one time barely to be seen, at an- 
other looking like Phlegmonous 
Erysipelas. This eruption coin- 
cided with the commencement of 
the menstruation. Going back to 
its origin, I elicited the following 
curious fact : — 

Just before her twelfth year, she 
was one day out in the fields in 
sultry weather at hay-making, and 
while thus greatly heated she fell 
head foremost into a brook, and 
some days thereafter she broke out 
all over head and face with an 
eruption " just like small-pox." 
Her whole face and % ears were 
covered, and discharged so much 



io6 Diseases of 

that her mother had to tie a hand- 
kerchief round her neck to prevent 
its dropping on her clothes. She 
was indoors eight weeks with it. 
" Since then," she exclaims, " I 
have had any amount of medicines 
and greases, and all sorts of things, 
but they never did me one bit of 
good!" She has often a terrible 
sinking at the stomach, as if she 
had a large hole wanting filling 
up, together with a pressive head- 
ache at the top. Bowels regular, 
menses very painful — a hot, bad 
pain across the hypogastrium at 
the beginning. 

The present state of the face is 
just this : — The % right cheek and 
right side of the face generally are 
occupied by a red, tuberous erup- 



the Skin. 167 



tion, some of the angry protuber- 
ances being as large as big peas, 
and some only papules, and every 
size between. Nosologically: Peri- 
odical Dermatitis. 

Now, as to the remedy. I was 
greatly struck with the history of 
the case, and I reasoned thus: It 
arose primarily from the effect of 
cold water applied to the heated 
surface of the body (or rather con- 
versely), and that must surely be 
very like drinking cold water when 
overheated, and that brought 
Johannes Schroeder's observation 
to my mind, viz., that Be His 
was considered a capital remedy 
for such as had partaken of cold 
drink when the body was over- 
heated. This is, of course, an ex- 



108 Diseases of 

tension of his application of its use, 
but the same idea underlies it. 
How do we know but cold drink 
taken into a heated body produces 
internal erysipelas ? If, in the end, 
this idea be found to bear useful 
therapeutic fruit, it will doubtless 
be found in strict conformity 
with the law of similars. All my 
observations tend to that con- 
clusion. But considering Bellis 
perennis as analogous in its action 
to Arnica gives a fair reason for its 
use in this case, as Arnica both 
causes and cures Erysipelas. 

Therefore ffc Tc. Bellis per. 3* 
3iv. 

S. — Three drops in water three 
times a day. 

Oct. 22nd. — Face is quite well ; 



the Skin. 109 



has not liad a speck for the past 
fortnight or more. It left gradu- 
ally. She is actually menstrua- 
ting (it began yesterday), and 
her face is quite free for the first 
time at the beginning of the flow 
in her whole menstrual life, which 
began eighteen years ago ! ! Her 
bowels have become confined, and 
she has now, but only after food, 
a queer shaking, beginning in the 
pit of the stomach, and going tip to 
the throat, precisely as if she had 
been running fast. 

To take two drops only once a 
day, and come again in five weeks. 

Nov. 24th. — Has continued well 
of the eruption ; last poorly time 
not a spot ! 

She came occasionally for two or 



no Diseases of 

three months to report herself, and 
thus I can affirm that it so far 
remained permanently cured. 

The Bellis did not affect either 
the sinking at the stomach or the 
pressive headache on the top of the 
head at all ; so, early in December, 
I gave her Sulphur 30, one drop at 
bedtime for twelve days, when these 
two symptoms also disappeared. 
It is to be noted that these two 
symptoms were of much later date 
than the facial dermatitis. 

Of course, my reasoning in the 
foregoing case might be faulty, but 
I think it shows that the Daisy is a 
notable remedy, and this virtue of 
a common weed lying everywhere 
at our feet deserves to be made 
very widely known. People of 



the Skin. in 



any experience do not need to be 
told that the ill effects of drinking 
cold drinks when the body is 
heated are very serions at times, 
and always inconvenient. Of 
course it is not confined to the 
drinking, as the idea is sudden wet 
chill to heated stomach or body sur- 
face. This property of the Daisy 
is the more valuable, as we know 
of no other remedy in our vast 
Pharmacopoeia that possesses it ; 
and, beyond myself, I believe no 
one is acquainted with it. Most 
of what I here write has been 
lying in a drawer of my writing- 
desk for years, and this little 
clinical tip ought long since 
to have been published, for 
it may be a good while before 



H2 Diseases of 

another lover of the fair Daisy 
stumble against old Schroeder's 
generalization in a humble recep- 
tive mood. I regard this peculiar 
property of the Daisy as eminently 
important, and ask all who may 
read this to make it known, so 
that it may be available for such 
as travellers, tourists, harvesters, 
soldiers on the march, when they, 
being heated, have had a cold 
ducking, or have drunk cold 
liquids. 

I would recommend it also in 
the acute and chronic dyspepsia 
from eating cold ices, as the con- 
ditions here are identical, for I 
have, in such cases, found it an 
eminent curative agent. 

I should like very much to 



the Skin. 113 



dilate on the remarkable thera- 
peutic virtues of the Daisy, but this 
is not the place. This much is, 
however, apposite, for the Facial 
Dermatitis was one that would 
certainly be classed as a Disease 
of the Skin, and internal treatment 
alone cured it. — Q. E. D. 

Quite lately I have information 
of the cure by Bellis perennis of a 
severe case of Facial Acne, pro- 
duced originally by patient's rush- 
ing about in the cold air while her 
face was in a very heated condi- 
tion. 








PART II 



OBJECTIONS to the first 
edition of this little treatise 
were raised largely because of its 
essentially theoretical character ; 
well, that is really a compliment 
to the writer, whose object was to 
point out how entirely wrong are 
the commonly accepted views as to 
the nature and cure of cutaneous 
affections, and not to show that X 
cures Y. In some cases of disease 
it may, perhaps, not very much 
signify what views of aetiology and 
pathology the treating physician 



Diseases of the Skin . 115 

ma}' have ; but I submit it makes 
all the difference in the world when 
we are dealing with skin diseases. 
If the position which I take up 
be the true one, skin doctors are 
working great evil in the world, 
and sadly need enlightening; while, 
on the other hand, if they are 
right, and their almost universally 
accepted views and practice are 
sound and in accordance with the 
facts of disease, then I must be in 
the wrong, and wrong should every- 
where be crushed like a nut under a 
steam-hammer. Dermatologists ! I 
ask no mercy, as I give no quarter. 

Sine Ira et Studio. 

We all subscribe to this saying, 
sine i7-a et studio, but in the search 



n6 Diseases of 

after light and real facts we are all 
apt to become merely advocates of 
our own pet notions. Said a gentle- 
man to me one day, " Doctor, I 
have read your book ; you ought 
to have been an advocate ; I do not 
know about your facts!" With 
that he ran off laughing, and was 
clearly of opinion that he left me at 
full length in the dust. Well, 
thought I, I will consider afresh the 
whole question of Diseases of the 
Skin from the standpoint of the 
organism as an entirety, and as my 
little book on the subject, published 
in 1886, is out of print, and my pub- 
lishers are asking for a new edition, 
I will give just a few of the results 
of my reconsideration in this second 
edition. Here they are. By the 



the Skin. 117 



way, the clinical material made use 
of in the first edition came down to 
the commencement of the year 
1885, so far as my own case-takings 
in my own practice were concerned, 
and at this point I will resume my 
task. 

Case of Ichthyosis. 

A lady of 73 years of age came 
to consult me in the month of 
March 1885 ^ or l° ss °f vision due 
to double cataract. In dealing 
with cataract I always go at once 
to a consideration of the skin, and 
here the find was instructive ; her 
skin was very thick, dry, hot, and 
scaly, notably on the extensor sur- 
faces, with long cracks here and 
there. In her movements patient 
9 



n8 Diseases of 

is exceedingly slow, spending as 
much as two Hours at her very 
simple morning toilet. Though her 
skin had never been other than 
dry and scaly, it is getting much 
worse of late years. Her lenses 
were opaque and of a milky colour, 
and the epidermic scales light- 
coloured, though not particularly 
pearl-like, — just a case of chronic 
diffuse hypertrophic keratosis. 

This lady has continued under 
my observation up to the present 
time, and so would now be in 
her 79th or 80th year. She 
was nearly blind when she came 
to me, being just able • to find 
a large object; thus with a little 
groping and feeling with her knees 
she could find a chair to sit upon. 



the Skin. 119 



There were temporary improve- 
ments in vision here and there, and 
the lady has still a very small 
amount of vision. Bnt on the 
other hand, there has been a very 
distinct improvement in her skin, 
which is neither so thick nor so 
scaly, nor so mnch cracked. And 
considering the age of the patient 
and the very long duration of the 
affection, I think the improvement 
in her skin very noteworthy indeed, 
and her various ailiugs have been 
from time to time much relieved as 
well. During the five and a half 
years she had from me many 
remedies, — Calcarea fiuorica 6, 
Psoricum 30, Natrum muriaticum 
30, Psor. c. y Thuja 30, Lactuca vir. 
3, Galium aparine i* } Platanus occi- 



120 Diseases of 

dentalis i* \ Graphites 30, Ichthyol 
30, Baryta mur. 3*, and here — 
August 1887 — there was very dis- 
tinct amelioration both in the skin 
and lenses. Calcarea hypophos- 
phorosa 3^, Aconitum 3*, Aurum 
muriaticum natronatum 3*, Pul- 
satilla, Bryonia, Borax, Be tula 
alba #, Juglans cinerea. 

The remedies that were of very 
distinct advantage were Barium 
and Platanus. Under Barium for 
several months patient increased 
in vigour and well-being, and 
under the Platanus for several 
months also her skin admittedly 
underwent considerable improve- 
ment. 

The Betula alba patient credited 
with rendering the skin much 



the Skin. 121 

more comfortable, but complained 
that it affected the upper part of 
the body only. 

A friend of this aged lady spoke 
slightingly of the treatment of this 
case, inferring that as the case was 
not cured, the whole thing was a 
fiasco. But I pointed out that 
what results from the treatment is 
strong evidence of beneficial drug- 
action in a very inveterate case at 
an advanced age ; that the lady's 
discomforts have been greatly alle- 
viated ; that at 78 her skin is actu- 
ally much better 'than it was at 73 ; 
while at 73 it was getting worse 
and worse, her skin at 78 is not 
getting worse, but better. 

The fact that the lady's span of 
life is dwindling has nothing to do 



122 Diseases of 

with the clinical evidence of cura- 
tive results from drug-action, or 
rather the greater the age of the 
patient the more remarkable the 
evidence. We must remember that 
what we call life is to each indi- 
vidual of us a varying quantity, 
according to our respective ages, 
and at 78 life to this lady is what re- 
mains to come after 78 ! It may not 
be much, but it is life to her : in 
other words, alleviating an old pa- 
tient is, medically speaking, not 
diminished because the patient ben- 
efited may not have long to live by 
reason of advanced age, — 

" At six I well remember when 
All folks seemed old at ten." 



the Skin. . 123 



Severe Case of Eczema of Six- 
teen Years' Standing — Ele- 
phantiasis Labiorum Vuly.e— 
Life-long Constipation. 

A strong, well-preserved lady, 
70 years of age, came under my 
observation on October 9th, 1890, 
telling me she had very severe 
eczema for the last sixteen years, 
and now for some time past has 
what has been called dry eczema of 
the vulvar lips, and there is also a 
patch of " dry eczema" over her 
right eye. Both the vulvar lips of 
the right side were hugely enlarged, 
and appeared as a big flap of ele- 
phantine nature, scaly, shiny, deep- 
ly pigmented, reddish in spots, dry 
and itchy. Patient, though English 



124 Diseases of 

and long resident in England, is, 
nevertheless, of West Indian birth, 
having left her birthplace and came 
to this country at the age of 6 years, 
— i. e., sixty-four years ago. I men- 
tion this point because I do not 
remember ever seeing a case like 
this before, and hence presume it 
cannot be common in London, or 
generally in this country. The ir- 
ritation was very bad ; worse after 
sitting or walking much, and also 
at night, when it keeps her awake ; 
it is much worse in the cold weath- 
er, diminishing much in the warm 
weather of summer. Patient en- 
joyed good health, and has never 
had anything beyond measles, scar- 
latina, and pertussis. She com- 
plains of being chilly. Nothing 



the Skin. 125 



seemed to account for so severe an 
affection in an otherwise strong, 
health}^ lady. There had been in 
all three vaccinations, the third 
one having been unsuccessful, and 
was in 1871. The eczema had first 
obtruded itself upon patient's at- 
tention sixteen years ago, — z. e., 
subsequent to this third unsuccess- 
ful vaccination. 

f& Thuja 30. 

October 30, 1890. — The little 
patch of eruption over the eye is 
well, the labial swelling is less, the 
mass softer, and patient exclaimed, 
" I feel quite different. " 

J$ Sabina 30. 

November 20. — Not any further 
improvement. 

f& Vaccininum 30. 



126 Diseases of 

December 18. — The bowels have 
acted twice every day, and she had 
been costive all her life ; has been 
always in the habit of going six or 
seven days withont any motion, and 
then art and physic had to do it. ''Dr. 
Bell (homoeopath) treated my con- 
stipation for long, and finally gave it 
up as a constitutional peculiarity." 

U Maland. CC. 

January 8, 1891.- Patient cried 
out to me on this day : — " English, 
French, German, allopathic and 
homoeopathic, — all have tried at my 
costiveness in vain, and now the 
bowels act so well." The elephantine 
skin of labia steadily improving. 

Feb. 5. — Skin healing well ; 
bowels not quite so comfortable. 

Ijk Vaccininum 30. 



the Skin. 127 

Feb. 26. — Skin affection improv- 
ing; bowels act comfortably. "I 
have never felt so well in my life." 

f& Nux 30, nnder which the 
bowels went back. 

March 19. — Vacctn. } 30. 

May 21. — Well ; bowels act qnite 
regnlarly and comfortably ; and 
thongh patient feels not qnite com- 
fortable at the vulva, objectively 
the skin is quite normal. 

At the end of November the skin 
continued quite normal, and hence 
we may conclude that the cure is a 
perfect one. 

Nine months later. — The cure 
holds good. And this radical cure 
of an old-standing ailment in a lady 
of 70 years of age, — the remedies 
used being all given internally, and 



128 Diseases of 

not only so, but in dynamic doses 
(and frequently) , — this cure, I say, 
is noteworthy, and tells well for my 
thesis that skin diseases are of con- 
stitutional nature, and must be so 
regarded and treated. Natura \or- 
ganismus] sanat, medicus curat. 

Case of Acne and Swelled 

Neck. 

On February 10, 1891, an un- 
married lady, well on towards 30, 
came to consult me for roughness 
of the skin of the face, and acne. 
She did not mind her cough, it was 
not so very bad, nor did she make 
much ado about the rather profuse 
expectoration of phlegm. She did 
not even complain of her enlarged 
tonsils or leucorrhoea, and as for 



the Skin. 129 



her chilblains, they only came in 
very cold weather. Said she, " It 
is my rough skin and this horrid 
neck." The " horrid neck" was 
made up of a one-sided enlarge- 
ment of the neck, consisting of a 
very much, hypertrophied sub- 
maxillary gland and tonsil of the 
same side, with, some puffiness of 
the surrounding areolar tissue, so 
that the side of the neck appeared 
M horrid," — 1. e., shapeless, and 
neck and face ran into one another, 
the jaw-bone line being lost. Thuja 
30 for a month distinctly lessened 
the size of the glands (submaxil- 
lary and tonsil), but cough and 
phlegm were not touched. 

Bacillinum C. was followed by 
much improvement, the unshapeli- 



130 Diseases of 

ness having changed : the jaw had 
become well defined, and thus neck 
and face no longer ran into one 
another, while the left submaxil- 
lary gland stood out by itself. The 
tonsils had gone down, but the 
quantity of phlegm, though less, 
was still considerable. I then went 
up to Bac. 1000. " Those powders 
did a wonderful thing for my skin : 
it went quite clear." 

July 21, 1 89 1. — Patient is quite 
well ; skin clear ; tonsils normal ; 
left submaxillary enlargement 
gone ; neck restored to its pristine 
shapeliness ; and not long after this 
she was engaged to be married, 
and in the early autumn the mar- 
riage came off. 

My reading of the whole case 



the Skin. 131 



was to the effect that I was dealing 
with vaccinosis and scrofulosis 
bordering on tuberculosis. May I 
put the pertinent question to any 
dermatologist or surgeon in this 
wide world of ours : What would 
you have done in this case? 

August 1892. — Patient continues 
quite well, as I learn from her 
mother, Lady X. 

Ulcerative Eruption of Vulva. 

A lady of 50 years of age, for 
many years married, but childless, 
came under my care for troubles 
connected with the climaxis, not the 
least of which was vaginal and 
vulvar irritation, as w r ell as a very 
extensive ulcerative eruption all 
over the labial and vulvar region 



132 Diseases of 

extending at times as far as an inch 
and a half on to the circumvulvar 
region, but when it came into the 
common integument it took more 
the form of eczema, with a few 
pustules here and there. The flat 
ulcers in the labia and nymphae 
had plagued her years ago, and 
been cured (silenced) by cauteriza- 
tion. I& Tc. Platin. mur. 3*, three 
drops in water twice a day. 

In a month the eruption had 
materially diminished, having lost 
its pustular and purulent character, 
and the vaginal discharge had 
entirely ceased. 

Here {May 27, 1887) Lachesis 
was ordered, and with advantage. 

July 7, 1887. — The thing has 
returned. 



the Skin. 133 



Tfy Tc. Aurum mur. nat. 3^, four 
drops in a tablespoonful of water 
night and morning. 

This completely cured the erup- 
tion with its concomitants, the rem- 
edy having to be once subsequently 
repeated : in all, the Auric salt was 
taken during about thirteen or four- 
teen weeks. There has been no 
return, and the lady continues in 
excellent health and condition. I 
used no local application whatever. 
And here I may state, once for all, 
that I hardly ever order local appli- 
cations of any sort in cutaneous 
affections. If in any of my cases 
herein recited any local applica- 
tions are used, the fact will be 
stated ; but I believe that in no 
case herein communicated was any 
10 



134 Diseases of 

local application whatever used, so 
far as I am aware. Not only so, 
but I commonly specially warn my 
patients against all ointments and 
lotions whatever, as I find that 
Goulard's lotion, Zinc ointment, 
Citrine ointment, Golden ointment, 
and the like, may be found in very 
many households, and it is very 
difficult to prevent their being 
used. 

The use of remedies applied as 
ointments or lotions is absolutely 
bad; and when I read of the homoeo- 
pathic treatment of skin diseases 
whereby ointments and lotions play 
a part, my respect for the quality 
of such treatment is small indeed. 
It is wonderful how people will 
cuddle and fondle the ointment 



the Skin. 135 



pot ; and " Regular Medicine " 
would be indeed badly off without 
its grease-pot and clyster. I often 
think the use by the homoeopaths 
of their Calendula cerate or oint- 
ment comes dangerously near the 
thin end of the wedge of the 
vulgarly-conceived putty-and-paint 
treatment of the medicine of the 
schools. 

It is almost incredible, but the 
discovery of a new fat for an un- 
guental excipient is an event of the 
first magnitude in the dermatologi- 
cal world, the vault of whose 
heaven is still ringing with the 
echoes of the wonders of vaseline 
and lanoline. And what does it all 
amount to? 

A pat of pig's lard. 



136 Diseases of 



Case of Pityriasis Rubra. 

Although the Vienna School 
classifies this rather rare affection 
with eczema, I cannot see myself 
whereon the classification is based ; 
but I have only had to treat two 
typical cases of it, both being of the 
cutaneous covering of the chest, 
and two or three cases of symptoms 
of the rim of the hairy scalp, which 
were distinctly of the same nature. 
The patient here referred to came 
to me on December 22, 1885. A 
powerful peer of this realm and a 
great Nimrod, with flesh as hard as 
nails, he came to be treated for a 
maddening neuralgia he had picked 
up on the banks of the Nile ; 
remedies having cured his neu- 



the Skin. 137 



ralgia he showed me his chest, 
which was the seat of a big patch 
of red pityriasis that he had had 
for a number of years, — the precise 
number I do not know. I saw 
him, off and on, for nearly five 
years, and gave him a not inconsid- 
erable portion of our Pharmacopoeia 
(andour Pharmacopoeia is not small 
— see Allen's " Encyclopaedia of 
Pure Materia Medica!"), but the 
pityriasis rubra remained .... 
Pityriasis rubra. I should say the 
big patch was composed of a series 
of smaller patches, all more or less 
circular or segments of circles. 

One day I was reading in an old 
German book that some sailors — 
British, I think — many years ago, 
in some of the Pacific islands, ate 



138 Diseases of 

of a fish called erythrinus, and 
came out with a peculiar red rash 
that became chronic, and which the 
doctors took for a form of syphilis. 
Dr. Alfred Heath, F.LS., with 
his wonted devotion and disinter- 
estedness, procured this erythrinus 
for me, and prepared it homoeo- 
pathically, and I, on March 23, 
1889, ordered' as follows : J$ Tc. 
Erythrinus 1 Sj., five drops in water 
night and morning. I did not see 
the patient after for about two and 
a half years — viz., September 1, 
1 89 1. When I inquired of him 
about the " red patch on his chest," 
" Oh,'" said he, " you cured that 
long ago with that big bottle of 
stuff you sent me," z*. e., — the ounce 
bottle of Erythrinus 1, 



the Skin. 139 



The second case of pityriasis 
which I treated with this Ery- 
thrinus is greatly improved, but by 
no means cured. The father of the 
gentleman who was cured by Ery- 
thrinus had had syphilis, as I ascer- 
tained from an indirect but very 
reliable source. 

The father of the second case 
died of what seems to have been 
aneurism of or near the heart. It 
may therefore be worth while to 
ascertain whether pityriasis rubra 
be not a syphilitic manifestation in 
the second generation. That it is 
not eczema I am very sure. It is 
worthy of note that the second 
patient to whom I here refer, — who 
is not cured, and is still under my 
treatment, — came to me originally 



140 Diseases of 

for heart disease characterized by 
distress in the heart region, palpita- 
tion, irregular heart-beat, and 
much distress on walking, particu- 
larly up hill. 

For this cardiac affection (which 
the regimental surgeon said would 
be fatal) I prescribed Aurum 
muriaticum 3*, at one time three 
drops, and at another time two 
drops, and finally five drops, in a 
tablespoonful of water three times 
a day. This cured the heart rather 
slowly, but the patch of pityriasis 
became twice as large. This vicari- 
ous phenomenon between heart 
and the skin of the thorax I have 
observed over and over again. So 
that when an individual has an 
eruption on his chest, he is not wise 



the Skin. 141 



to let any skin specialist treat it 
from the narrow standpoint of the 
specialist, lest heart disease super- 
vene. See here anent my remarks 
upon the " Sternal Patch." By the 
way, the " Sternal Patch " is in the 
lowest third of the sternum, rather 
to the right; this thoracic pityriasis 
patch is rather to the left, and just 
over the arch of the aorta. The 
" Sternal Patch" is not a brown, 
so-called, liver mark, but an erup- 
tion ; the importance of this erup- 
tion lies, I think, not so much in the 
kind of eruption as in the fact that 
when it vanishes from the surface, 
without being really cured from 
within, symptoms of heart disease, 
more or less grave, at once super- 
vene. The more one really studies 



142 Diseases of 

skin diseases the more one is struck 
with their habitats, which are often 
constant and characteristic. What 
are the internal pathological condi- 
tions corresponding hereto ? With- 
out doubt such exist, and have also 
a definite significance. 

Case of Violent and Severe 
Attacks of Arthritic Urti- 
caria. 

A lady of position, nearing 70 
years of age, of very abstemious 
habits and a strict dietarian, had 
been for years subject to violent 
and severe attacks of gouty nettle- 
rash, taking her suddenly, now in 
one part, now in another, and 
compelling her to hasten to her 
own apartments to apply hot wraps 



the Skin. 143 

to allay the furious itching. She 
had been under most of the better- 
known homoeopathic physicians in 
England one time and another, 
and had obtained a little temporary 
relief sometimes, but not much, so 
that she had given up all hope for 
long, and only consented to try 
again at the earnest solicitation of 
a friend. When she took my pre- 
scription into her hand, she ex- 
claimed, " Oh ! that's your tincture 
of nettles : that's no good. I have 

tried that under Dr. , and my 

dear old friend the late Dr. Hilbers 
also gave it to me." She persisted 
in it that Urtica would do her no 
good, but I persuaded her to take 
it {Urtica urens #), five drops in a 
wine-glassful of warm water three 



144 Diseases of 

times a day ; and much to her sur- 
prise, it did her so much good that 
she continued to take it for some 
months, and then discontinued its 
use, considering herself cured. 

In connection with this case it is 
worth remembering that Urtica 
had in old times quite a reputation 
for gout and sand, and I have re- 
peatedly noticed that patients, 
while taking Urtica ur. in the 
manner just described, have passed 
large quantities of sand, and in 
several instances such patients 
have been alarmed, never having 
passed any before in their lives. 

Urtica urens is a very notable 
splenic, and with its aid I have 
often cured ague. And for the 
common manifestations of pure 



the Skin. 145 



gout, it is my sheet-anchor for years 
past. I could fill a little book with 
cases in proof of this statement. 

Dyspepsia — Vomiting — Neural- 
gia — Neurasthenia — Acute 
Eczema. 

A married lady, childless, 55 
years of age, came to me on July 
12, 1887, quite broken down in 
health ; it was thought the final 
break-up of the constitution was at 
hand. The most prominent and 
most distressing symptom was 
perhaps her attacks of faintness 
and her inveterate and severe dys- 
pepsia, though she felt her nerve 
symptoms very mnch. She was 
afraid of being alone, going about 
in fear and trembling. Nervous 



146 Diseases of 

heart-beat ; spleen very much en- 
larged (affirmed that she had had 
ague every spring until she was 
nearly thirty years of age) ; a good 
deal of neuralgia in the left side of 
head and face. She is intolerant of 
cold, and revels in this July heat. 
This lady is an amateur artist, and 
paints a good deal these many years, 
and wonders if her frequent attacks 
of vomiting have any connection 
therewith. She formerly had vari- 
ola and measles, and has also 
suffered from urticaria. But the 
fact that she had been twice vac- 
cinated seemed to me the most 
proximate and least questionable 
therapeutic indication. Hence I 
started off with Thuja 30. 

August 11. — Was quite well till 



the Skin. 147 



two days ago ! No vomiting ; 
slight neuralgia only ; no fainting 
attacks; tongue now thickly coated. 

The next most obvious point to 
attack was the greatly enlarged 
spleen and the chilliness. 

]J Ceanothus Americanus 1. Six 
drops in water night and morning. 

December 1. — My patient came 
this day and bitterly complained 
that the Ceanothus had done no 
good at all, and had, moreover, 
brought back all the old symptoms, 
which the Thuja powders had so 
much benefitted. The neuralgia is 
bad again, and patient very ear- 
nestly requests that she have the 
old powders again. 

So Thuja 30 was again prescribed 
in very infrequent doses. 



148 Diseases of 

January 17, 1888. — Has a bad 
attack now on these eight days, 
and there is a little eruption on the 
tips of her toes and fingers ; no 
vomiting. 

Ijk Ignatia amara 1. 

February 19. — Much better ; in 
fact, feels wonderfully well, but she 
has " broken out all over with an 
eruption of water and matter y And 
she now has ceased to be cold, and 
is, on the contrary, hot. 

5> Tc. Juglans regia 0. Five 
drops in water night and morning. 

March 27, — The skin has im- 
proved a good deal ; as the eruption 
dies away the locus turns brown ; 
the eruption is now worse on the 
hairy scalp ; she feels sick and 
dizzy. Never had any eruption 



the Skin. 149 



other than urticaria till after she 
took the Thuja from me. Much 
better in all general respects. 

Bj Rep. 

May 8. — Been sick again, three 
times ; many brown marks where 
the eruption was, otherwise she is 
well and the skin is quite healthy. 
The spleen, however, continues 
hypertrophied. 

R Urtica urens 0. Five drops 
in water night and morning. 

October 6. — Bowels costive; feels 
tired and bilious, and complains 
very much of feeling shivery and 
cold Natrum muriaticum 6 tritu- 
ration cured these symptoms, and 
patient was discharged cured. 
July 1893. — The cure holds good. 



11 



150 Diseases of 



Case of Strumous Eczema in a 
Baby, cured by Bacillinum CC. 

One meets not infrequently with 
bad cases of eczema in babies that 
are apt to end in marasmus and 
death : the eruption in such cases is 
almost all over the body, wetting, 
more particularly in certain more or 
less circumscribed patches, and driv- 
ing the poor little patients almost 
mad with irritation, particularly at 
night. I had such a case this last 
summer in a baby of only a few 
months of age, and who was partly 
on the cursed bottle. Did I say 
cursed bottle ? I will withdraw the 
wicked word and ask my readers to 

allow me to substitute for it , 

well, I mean the strongest word of 



the Skin. 151 



condemnation known in our lan- 
guage. In this particular case the 
mother did her best, so the use of 
the bottle could not be avoided, 
and its use was only partial, the 
mother giving all she had. 

Well, I had treated the eczema 
for some weeks with no benefit, 
when one afternoon I was suddenly 
summoned into the country to see 
this poor bairnie, and a sorry sight 
it was. 

, Mother and nurse were at their 
wit's end to know how to keep the 
wet patches from sticking to the 
clothes, fat-besmeared rags only 
sufficing for a very short time. 
Hardly any sleep at night from the 
furious irritation. I then remem- 
bered that I once cured an elder 



152 Diseases of 

baby-brother of this little patient 
of eczema of the scalp with Baal- 
linum, originally suggested by the 
ancient scars in their father's neck, 
now well hidden behind his long 
beard I therefore ordered for my 
wee patient BacilL CC. in infre- 
quent doses. 

In one week the report ran : 
" . . . Baby is much better, and 
now sleeps and feeds beautifully." 

I need only add that the remedy 
quite cured the case, and the little 
lassie got quite well, and so remains. 

Such cases are very apt to end 
fatally, whereof I have been in 
times past more than once the 
sorrowful witness ; but then I knew 
nothing of Bacillinum in high 
potency, or, indeed, in any potency. 



the Skin. 153 



The patient in question had not 
at that period been vaccinated. 

Inveterate Eczema. 

An American gentleman, 63 
years of age, came under my 
observation on May J4, 18*87, ^ or a 
very severe eruption on the skin — 
inveterate eczema — of many years' 
duration. Latterly it has been 
getting much worse and more 
extensive, and extends now to the 
penis, prepuce, and eyelids and 
conjunctivae. There was a specific 
air about it, but this was strictly 
denied, a gonorrhoea only being 
admittedly historic. 

I began with Platanus occiden- 
talis 0, but in eight days from its 
commencement patient returned to 



154 Diseases of 

me, bitterly complaining that there 
was no improvement. 

May 21. — Six grains of Aurum 
metallicum three times a day. This 
did him some good certainly, but 
not very much. Then followed 
Mercurius solubilis Hahn. in a low 
trituration, aud it was soon clear 
that we had hold of the right rem- 
edy, but it would not quite finish 
the cure, though it came very near 
doing so. A month of Kali chlor. 
3*, and patient considered himself 
cured, except the redness of the 
eyes. This ophthalmia was cured 
by Jequirity 3*, six drops in water 
night and morning. 

I saw this gentleman a year and 
a half later, when he declared him- 
self quite well in health and free 
from eczema. 



the Skin. 155 



Case of Gouty Eczema. 

In the autumn of 189 1 a gentle- 
man of about 60 years of age con- 
sulted me in regard to a very 
severe form of eczema occupying 
the genital, perineal, anal, and 
crural regions : the surface was red, 
raw, shiny, scaly in part, and in 
part moist. The thing caused him 
very great distress. The first two 
prescriptions did him no real good, 
so on November 27th, 1891, I pre- 
scribed the hippurate of sodium in 
the fifth centesimal dilution in ten- 
drop doses, administered every 
night and morning, I sending him 
enough to last a month. 

I saw no more of him till the 
spring of 1892, and then I inquired 



156 Diseases of 

of the skin trouble. " Oh ! that 
tincture cured me completely." To 
be quite sure it was so, I carefully 
examined the parts, and I did the 
same again four months later, when 
he called to ask me to suggest a 
place where he might with advan- 
tage spend his holiday. I found 
no trace of eczema on either occa- 
sion, and patient continues in good 
health. I have seen and treated a 
good many cases of eczema, and 
am just beginning to recognise its 
rather numerous varieties from the 
setio-pathological standpoint, and 
I shall yet have more to say on the 
subject : here let the simple narra- 
tive of the case cured by the hip- 
purate of sodium suffice. 



the Skin. 157 



Lichen Urticarus. 

A sixteen-months' old baby was 
brought to me by its mother on 
November 27, 1886, to be treated 
for wheals on its body that became 
much worse in the warmth of the 
bed : the distress of the child was 
great ; it got hardly any proper 
sleep. 

fy Syph. CC. 

January 13, 1887. — " These little 
powders quite cured baby in less 
than a fortnight." 

August 30, 1887. — " Babj^'s skin 
continues quite well." 

Cases of wheals in the skin of 
young children are very common, 
and the irritation they cause as the 
sufferers get warm in bed is often al- 



158 Diseases of 

most maddening. I have known 
such patients toss and roll about 
almost every night, and not infre- 
quently roll out of bed in their 
sleep, as if they were making des- 
perate efforts to escape from their 
tormentors. 

Chloral hydrate and Urtica urens, 
and also Persicaria urens are very 
useful in such cases, and so is also 
Bacillinum. But where the noc- 
turnally appearing wheals are, as it 
were, echoes from the paternal past, 
nothing equals the remedy here 
named as curative. The thing is 
cured root and branch, recurring 
occasionally when a new tooth 
sprouts, when the dose has to be re- 
peated once, or perhaps twice, till 
the cure is definitely completed. 



the Skin. 159 



Where the primary causation is 
from the effects of vaccination, 
Thuja, Sabina, Cupressus, Vaccin- 
inum, or Malandriniim may be 
used, Thuja generally sufficing; 
and I have required Acidum nitri- 
cum in some cases. 

Crop of Soft Warts Round 
the Anus. 

A middle-aged married gentle- 
man came under my observation in 
the summer of 1892 complaining of 
severe indigestion of long stand- 
ing : a good deal of epigastric dis- 
tress and pain characterized his 
dyspeptic state. Incidentally he 
complained of a most uncomfortable 
state of his anal region, and on ex- 
amining this part to ascertain the 



160 Diseases oj 

cause thereof I found a number of 
small warts arranged almost in a 
ring round the orifice. A gonorrhoea 
of many years ago, as also several 
vaccinations, sufficed to constitute 
the diagnosis of Hahnemannic sy- 
cosis, and, indeed, Thuja occtd. in 
the 30th centesimal potency, and of 
infrequent administration, quite 
cured the dyspepsia, and also the 
anus. I carefully examined the anal 
region, and found that the ring of 
small soft warts had quite disap- 
peared. " I feel all right there now." 

Nasal Erythema. 

A lady, 53 years of age, came 
under my professional care in the 
summer of 1890, with erythema of 
the nose, or, as we might call it, 



the Skin. 161 

dermatic rhinitis. The nose was 
all red and swelled up, the inflam- 
matory action not in any way ex- 
tending to the cheeks, but involv- 
ing the right eye a good deal. In 
fact, patient is of opinion that the 
right-sided conjunctivitis was the 
starting point of the nasal erythema, 
and she tells me that she is subject 
to this ocular inflammation, off and 
on, for many years. 

Anamnetically there is not much 
to note, except that the lady had 
been vaccinated seven or eight 
times, but it had only taken three 
times. 

Under Thuja 30 the erythema 
was half gone in three weeks, and 
patient had visibly improved in 
condition. After two months of 



1 62 Diseases of 

the Thuja the eye was quite well, 
the erythema still only half well. 
Finding that the nose scabbed in- 
side, I put patient on Kali bichromi- 
cum 5, five drops in water night 
and morning for a month, and then 
patient was discharged cured. (See 
the pathogenesis of Kali bi.) 

Life-long Eruption on Scalp. 

A single gentleman, 35 years of 
age, came to consult me at the end 
of August 1887 for a coppery 
eruption of his scalp that he had 
had as long as he could remember. 
Besides this eruption he complained 
much of chronic insomnia and fail- 
ing memory. I first gave him the 
strong tincture of Fagus cup., five 
drops in water night and morning, 



the Skin, 163 



but after a month — viz., on Septem- 
ber 30 — lie complained that he was 
no better in any respect, — sleepless, 
forgetful, restless; the eruption bad; 
his breath very foul ; liver slightly 
enlarged ; spleen large and very 
hard. 

Syp. CC. 

November 11. — "I have slept 
famously ;" and both he and I were 
of opinion that his hair had gone 
darker. The eruption distinctly 
better. 

I& Spiritus glandium quercus 0, 
five drops in water night and 
morning. 

December 12. — Eruption nearly 
gone ; the spleen pains a little now ; 
insomnia quite a thing of the past. 

f& Tc. Car duns Mar ice . 



164 Diseases of 

He reported himself quite well of 
his coppery eruption on January 13, 
1888, and two years later it still 
continued well, and since then I 
have no further tidings of him. 

Chronic Crops of Boils and 
Acne. 

A young city man, 21 years of 
age, just entering a very important 
city firm,came under my observation 
on March 21st, 1888, complaining 
that for the past six years he had 
been suffering from crops of boils. 
They are worst on his nape and face; 
at this moment there is one on the 
nape, and also one on his nose. 
There are also mattery spots — acne 
— all over his shoulders. Patient is 
very rich and rather good-looking, 
and it is therefore not astonishing 



the Skin. 165 



that lie liad been under the profes- 
sional care of tlie leading physicians 
and surgeons and skin specialists 
of London, to the number of ten. 
Finding quite a goodly collec- 
tion of vaccinial scars on both 
arms, I inquired what number 
of times he had been vaccinated. 
Answer : Four times. Urine has 
a specific gravity of 1020, and the 
glands of his neck are visibly 
swelled. I had him about ten 
weeks under Thuja occidentalis 30, 
very infrequently adniinistered,and 
the boils and acne pustules all waned 
and went and came no more, much 
to patient's amazement, and, indeed, 
to my own, for I had not expected 
such a prompt and perfect cure. I 

subsequently often saw him with 
12 



1 66 Diseases of 

his younger brother, and so know 
that the cure was definite. The case 
was clearly one of pure and uncom- 
plicated vaccinosis without the dash 
of consumptiveness that so often 
lurks behind severe acne. 

There is also a kind of acne that 
is distinctly of arthritic nature, and 
this yields well to Urea 6 ; in this 
variety pustulation is much less pro- 
nounced than in vaccinial acne or 
phthisic acne. Broadly put, vac- 
cinial acne yields to Thuja occiden- 
talism Sabina and Cupresstis, also to 
Silicea and Maland.; acne from 
masturbation, to Bellis perennis ; 
phthisic acne, to Bacillinum; when 
the acne is very pronouncedly pus- 
tular and scarring, to Vaccinin. and 
Variolinum; and arthritic acne calls 



the Skin. 167 



for hippuric acid, hippurate of 
sodium, and Urea. The study of 
the varieties of acne is highly in- 
teresting and instructive, as almost 
all the great constitutional ances- 
tral diseases show themselves in 
young persons in the form of acne. 
Not infrequently cases of acne are 
of mixed pathological qualities, 
and these need all their pathologic 
simillima. Remedies only morpho- 
logically homoeopathic to the acne- 
form only palliate ; to really and rad- 
ically cure they must be patholog- 
ically similar. What a vast vista ! 

Ringworm (Herpes s. Tinea 
Tonsurans) . 

This is a very interesting com- 
plaint, and particularly so from the 



1 68 Diseases of 

biological standpoint ; bnt as I have 
written a little monograph on the 
subject, I must refer my readers to 
it for the fuller information which 
it contains. It is entitled " Ring- 
worm: Its Constitutional Nature 
and Cure" (London, 1892). It is also 
published in America by Messrs. 
Boericke & Tafel, and may be ob- 
tained at any of their pharmacies. 

The older remedies for its cure 
are Sepia , Sulphur, and Tellurium; 
my own special remedy is Bacilli- 
num in high potency, which is not 
merely a morphological simile, but 
what I conceive to be its patho- 
logical simillimum. 

In treating ringworm cases by 
Bacillinum it must be borne in 
mind that the constitutional crasis 



the Skin. 169 



is aimed at, and not the parasitic 
fungi. This is highly important, 
as the following narration will ex- 
emplify. Soon after the appearance 
of my little work on Ringworm 
just referred to, a very eminent 
London ringworm specialist, desir- 
ous of practically testing my treat- 
ment, sent a very delicate, stunted, 
strumous girl to me, saying, " Here 
is a case after Dr. Burnett's own 
heart. Tell him from me that I re- 
gret being unable to co-operate with 
him, as he is a homoeopath ; but 
you go and see what he can do." 
Well, that was, I must confess, 
very handsome of him. The 
mother brought the girl, and I put 
her upon Bacillinum and gave up 
all local treatment altogether. In 



170 Diseases of 



the course of about two months the 
improvement in the child's general 
health was very marked, and the 
parents were delighted ; but the 
precious fungi on the head haunted 
the child's mother so, that although 
she was very pleased to admit the 
great improvement in the child's 
appetite, sleep, temper, and appear- 
ance, still she wanted to know from 
the said specialist whether the para- 
sitic fungi were decreasing; and 
having taken her to him, it was 
found that the head was much 
worse !- — i. e., the number of fungi 
was much greater; and therefore 
my plan of treatment was given up 
as a dead failure ! It did not occur 
to these good people that my stand- 
point is the very opposite of theirs : 



the Skin. 171 



I deal with the organism, they deal 
with the parasites. The organ- 
ism was admittedly improved, the 
number of parasites demonstrably 
greater. I claim that the child 
was visibly getting better. There 
being more parasites, they con- 
sidered that she was worse, or at 
any rate that the ringworm was 
worse, although the patient was 
better in herself. 

Now, I not only do not claim that 
the number of parasites and their 
spores decrease in the beginning of 
my treatment, what I claim is that 
eventually they go altogether as 
soon as the organism is normally 
healthy. Of course, it must be 
obvious that there would be fewer 
parasites present on the head while 



172 Diseases of 

it was being scoured twice a day 
than while the head was let alone 
entirely. That the number of the 
parasites and their spores can be 
kept down by external parasiticidal 
treatment I do not for one moment 
dispute ; what I say is, that the 
parasites themselves are NOT the 
disease, but are merely the tricho- 
phyton mould living on the surface 
of a diseased organism; and, further, 
I incline very strongly to the belief 
that not only are the fungi harmless 
tothe patient, but probably actually 
beneficial as organismic scavengers. 

Do mushrooms come in a clean 
new stable, or in a dirty disused 
one ? 

Do toadstools grow on healthy 
trees, or on decaying ones? Which 



the Skin. 173 



existed first — the decaying wood or 
the toadstool ? Can yon cnre a de- 
caying tree by killing the toad- 
stools ? 

Fnngi live on decaying matter, 
and their fnnction is to nse np and 
get rid of snch decay ; and I am 
fnlly persuaded that the function of 
the trichophyton of ringworm is in 
harmony with thisgeneral principle 

It is inconceivable that j^ou can 
better the health of a child by clean- 
ing the ringwormy mould off the 
surface of its body. 

It is equally inconceivable that 
you should be able to keep ring- 
worm alive on a healthy individual; 
or, if so, then fish can live in the 
air, and a cow could live the life of 
a whale. 



174 Diseases of 



Alopecia Areata. 

This is an affection of the hairy 
scalp principally, and consists of 
shiny, bald, circnlar patches, in 
appearance not unlike the surface 
of a billiard ball. I do not think 
the affection can be considered a 
common one, though of course a 
few cases of it constantly pass before 
us. Authorities differ a good deal 
about it, particularly as to whether 
the decalvation be of epiphytic 
nature or not. 

But there is one point in regard 
to alopecia areata in which all the 
dermatologists and skin surgeons 
agree, and that is their treatment — 
viz., active irritants applied to these 
bald patches. This treatment is 



the Skin. 175 

simple, sometimes painful, me- 
chanically childish, and besides be- 
ing well-nigh universal, is at the 
same time quite useless except in 
very simple cases . Given a good stiff 
case of alopecia areata, and all the 
skin specialists and all the favour- 
ite irritants of all the dermatologists 
of the wide world cannot cure it. 

Hughes names Phos. acid, Fluoric 
acid, and Arsenic, and considers 
the second-named specific in the 
syphilitic form. 

Hughes also calls attention to 
Teste's singular experience with 
Aloes. 

Goullon (the second) praises 
Graphites, Baryta carbonica, Lyco- 
podium, Mercurius, and Natrum 
muriaticum. 



176 Diseases of 

In alopecia areata the only sound 
plan is to heal the patient rather 
than the alopecia. What the real 
nature of areata baldness may be is 
still a moot point. We shall not 
lose time if we inquire into this 
point somewhat. Probably few 
people know more about this subject 
than Mr. Jonathan Hutchinson, 
late President of the Royal College 
of Surgeons. We will therefore 
consult him on the subject. 

On Alopecia Areata and its 
Relation to Ringworm. 

Mr. Jonathan Hutchinson brings 
forward a series of cases {Archives 
of Surgery, April 1893), altogether 
39 in number, of alopecia, and seeks 
to connect them setiologically with 



the Skin. 177 



ringworm. He says lie does not 
think that anyone will read atten- 
tively the items of evidence (/. e., 
these 39 cases) which he brings 
forward without coming to the same 
conclusions he has arrived at him- 
self ; and the chief of these conclu- 
sions is, that " all well characterised 
cases of alopecia areata are in direct 
connection either with ringworm or 
pityriasis versicolor, and that they 
have little or nothing to do with the 
state of the patient' s general health . ' ' 
Our author reckons hereto all 
cases of loss of hair beginning as 
smooth bald patches which are ab- 
ruptly margined, which tend to 
spread at their edges, and which 
are attended by the development of 
others in their vicinity. 



178 Diseases of 

" In some cases the patient may 
lose every hair on the body in the 
conrse of a few months, whilst in 
others the patch may remain single 
and solitary for a year or more." 
" Differences in the rate and extent 
of progress do not seem to me to 
imply any difference in the essential 
natnre of the disease ; and I much 
doubt whether there is any class of 
cases in which the shedding of the 
hair becomes universal which are 
not of the nature of alopecia areata." 

Alder Smith (" Ringworm : its 
Diagnosis and Treatment," Lon- 
don, 1885) says alopecia areata " is 
due to a state of perverted nutrition 
and not to any vegetable parasite," 
and refers to a paper read at the 
International Medical Congress in 



the Skin. 179 



1881, on the Cause of Alopecia, by 
Dr. Liveing, proving its non-para- 
sitic nature. 

Alder Smith adds, " It is hardly 
necessary for me to remark that I 
fully agree with this view, having 
never been able to discover any 
fungus in the club-shaped stumps." 
So here, on the other hand, alopecia 
areata is declared to be /z<9;2-para- 
sitic ; and with regard to allowing 
a child with alopecia into a school, 
Alder Smith declares " there is no 
fear of the disease spreading ; and 
therefore children with alopecia 
may be allowed to attend school 
without any risk to others." 

The bald patches of alopecia 
areata commence most commonly 
at the back of the head, and Mr. 



180 Diseases of 



Hutchinson thinks this is due to 
the infection coming from cushions 
and the backs of chairs. 

Bringing ringworm and alopecia 
areata under one head is so import- 
ant, that I will give Mr. Hutchin- 
son's own concluding remarks, pre- 
mising merely that I do not agree, 
by any means, with some of his 
views. His final remarks are rather 
long, but demand earnest attention. 

Mr. Hutchinson's concluding re- 
marks on the relation of Alopecia 
Areata to Ringworm : — 

" Concluding Remarks. 

"It will be seen that amongst the 
cases which I have related there 
are many in which the evidence was 
quite clear that ringworm had pre- 



the Skin. 181 

ceded the alopecia. There are also 
some in which no proof of such con- 
nection could be produced. There 
are several in which twomembers of 
the same family, who had suffered 
at the same time from ringworm, 
became subsequently the subjects 
of alopecia. In several instances 
the history of the original attack of 
ringworm was, in the first instance, 
denied by the patient, having been 
either not known or forgotten, but 
was subsequently supplied. The 
cases are a fair specimen of my 
personal experience during the last 
few years in reference to the disease 
in question, and their results will, I 
suspect, differ only from those of 
other observers in that,being speci- 
ally interested in the point, I have 
13 



1 82 Diseases of 

been more patient than usual in 
seeking for the history of ringworm. 
Much patience is indeed necessary 
on this point, for I have found that 
almost invariably the first answer 
to the question, ' Have you ever 
had ringworm when a child ?' is in 
a strong negative. Some patients 
have quite forgotten it; some never 
knew what the disease was ; some 
doubted the diagnosis ; and one and 
all are very willing, if they can, to 
ignore the fact. Inquiries on this 
head must be expected to give 
negative results in hospital practice 
far more frequently than amongst 
private patients. The latter are 
more intelligent as to their ante- 
cedents, and can usually inquire at 
home as to what happened in their 



the Skin. 183 



youth, with much better hope of 
success. Ifreely admit that in a very 
considerable number of cases, even 
afterpainstakinginquiry,nohistory 
of antecedent ringworm is forth- 
coming. These cases, however, do 
not shake my belief in the creed 
that alopecia areata is a disease 
in connection with cryptogamic 
growth. I suspect that some of 
them are examples of direct con- 
tagion from alopecia itself; others 
of contagion to the heads of adults 
from ringworm in children ; and, 
lastly, others of contagion from pity- 
riasis versicolor. Concerning the 
latter malady, I have no doubt that 
it is transmutable with ringworm. 
My theory respecting alopecia is 
that it is due to some form of 



184 Diseases of 

cryptogamic life, which develops 
deeply in the hair follicle, and does 
not grow in the hairs themselves. 
I admit that this cryptogam has not 
yet been satisfactorily identified by 
the microscope, and that in the 
majority of cases the most careful 
examination will fail to give any 
indication of its presence. Alopecia 
areata is, however, a disease of such 
definite features, and of such re- 
markable sameness in its clinical 
history in different cases, that it is 
extremely difficult to entertain the 
belief that it depends on one cause 
in one case, and upon a totally 
different one in another. I cannot 
but think that its cases ought all to 
be placed in one group, and since 
the evidence is so strong that some 



the Skin. 185 



of them depend on antecedent ring- 
worm or upon direct contagion, I 
cannot escape the conviction that 
they all do so. 

" There are certain other facts 
which favour the belief just ex- 
pressed. Thus, although alopecia 
but rarely exhibits contagious pro- 
perties, it sometimes does so. Many 
authors have recorded instances in 
which it affected several members 
of the same family, and more than 
one series of facts are on record in 
which it prevailed as a household 
epidemic* 



*"By far the best example of epidemic 
alopecia with which I am acquainted was 
recorded in the Boston Medical and Surgical 
Journal, May 1892. I am indebted to Dr. 
Richmond Leigh for a detailed abstract of 



1 86 Diseases of 

" The entire absence of any form 
of ill-health in the subjects of alo- 
pecia areata induces me to put 

this important paper. It occurred in an 
orphan asylum for girls, and no fewer than 
sixty-one out of sixty-nine suffered. The 
first case occurred in January, the second in 
March, and between the latter date and June 
ist the total of sixty-one had been completed. 
The matron and four older girls who acted 
as her assistants escaped. Dr. Bowen and 
Dr. J. C. White, both of Boston, and dis- 
tinguished dermatologists, saw the cases, and 
both agreed that their general features were 
indistinguishable from those of alopecia 
areata and both failed, on microscopic 
examination, to detect the presence of any 
cryptogam. The hair-bulbs were wasted, 
as in alopecia. The bald patches are stated 
to have been smaller and more numerous. 
No preceding stage in the least resembling 
ringworm had been observed in any of the 
cases. Most of the cases were getting well 
in the course of a few months, and it was not 
thought that the cure was due to the use of 



the Skin. 187 



wholly aside any inquiry on that 
score. We may, I think, entertain 
absolute incredulity as to what is 
called the neurotic form of this 

any particular remedy. On this point, how- 
ever, there is much room for fallacy. 

u Whatever opinion we may incline to enter- 
tain as to the name which we should apply to 
the disease in this very remarkable outbreak, 
it appears to prove beyond dispute that 
there may occur a form of alopecia in patches 
which is actively contagious, and yet is un- 
attended by any fungus which the most 
modern methods of research can demonstrate. 
The narrative may be placed side by side 
with those respecting certain other maladies, 
not usually virulently contagious, but which 
may by a sort of accident become so. I 
allude to epidemics of pemphigoid porrigo, 
such as those described in Archives, vol. iii. 
p. 206, to those of puerperal fever, as related 
by the late Mr. Storrs of Doncaster, and to 
those of epidemic eczema in workhouses, 
which have recently claimed much notice in 
my pages. ' ' 



1 88 Diseases of 

disease. It attacks young people 
more frequently than others, and 
they are usually those in whom 
neither headache nor any species 
of neurotic disturbance had been 
observed. It does not appear to 
me to be worth while in such a 
malady to ask an adult patient as 
to overwork, mental worry, and the 
like. Such influences may be found, 
if sought for, in the majority of 
those who consult us, and I feel 
very certain that when they chance 
to be coincident with alopecia they 
do not stand to it in the relation of 
the cause. 

" The mode in which alopecia 
develops, the frequent, or indeed 
usual, absence of bilateral sym- 
metry, and of any definite uni- 



the Skin. 189 



lateral asymmetry, the rounded 
form of its patches, and their 
tendency to enlarge serpiginously, 
are also, I think, conclusive evi- 
dence as to its not being of neurotic 
origin. We know of no neurotic 
malady which has round patches 
that spread at their edges. 

" Lastly, I may allege that the 
modes of cure in alopecia areata by 
chrysophanic acid, creosote, blister- 
ing, etc., are all in favour of the 
belief that it is a disease of local 
origin. So also the facts that it 
always begins as a single patch, 
and, when it becomes general, 
spreads by the development of other 
patches from the parent as a centre, 
favour the belief in its cryptogamic 
nature. The facts as regards the 



190 Diseases of 

occasional re-growth of hair, and, 
after an interval, its falling off 
again, are very cnrions. They are 
not susceptible of satisfactory ex- 
planation on any theory that I am 
acquainted with, but they fit more 
nearly with some facts that have 
been established as regards crypto- 
gamic life than with any other 
hypothesis. 

u Summary. 

" I may venture to offer the fol- 
lowing conclusions as a summary 
of my present belief in reference 
to alopecia areata : — 

" ist. It is probable that all the 
cases which are well characterised, 
by abruptly rounded and quite 
smooth patches, are of one and 



the Skin. 191 

the same nature as regards causa- 
tion (possibly there is some slight 
exception to this in reference to 
syphilis) . 

11 2nd. It is probable that all 
cases of well-characterised alopecia 
areata are in some connection, re- 
mote or direct, with the presence of 
a cryptogam. 

" 3rd. Many cases, probably the 
majority, occur in patients who 
have, at some former period, them- 
selves suffered from ringworm. 

" 4//z. A few cases occur to those 
who have never shown signs of 
ringworm, but who have, at some 
former period, been exposed to its 
contagion. Some cases occur to 
adults as the direct result of ring- 
worm-contagion from children. 



192 Diseases of 

" $th. In a few cases it is possible 
that pityriasis versicolor on the 
chest of an adult may be the cause 
of alopecia areata on the scalp. 

" 6th. There are a few cases in 
which ringworm assumes, from the 
first, the features of alopecia areata. 
These may occur both in children 
and adults. 

jtk. Lastly, the explanation of 
the frequency with which alopecia 
areata begins on the back of the 
head is probably that it is caught 
by contagion from the backs of 
chairs and cushions, etc." 

Eczema of External Ear and 
Meatus. 

Miss Ethel S., 14 years of age, 
was brought to me on September 



the Skin. 193 



29, 1 89 1, suffering from a skin 
affection showing itself as eczema 
of the outer ear and meatus, the 
surface of which was wetting, 
shiny, and in part scaly, and the 
discharge would at times dry up 
into scabs. She has very large ton- 
sils ; her throat is swelled and irri- 
table, and in the early morning she 
feels sick. Her father was formerly 
cured by me of eczema ; and hence 
the young lady was brought to me. 
She was cured in about six months, 
the remedies being Med. 1000, and 
Bacill. 1000 and CC. 

This young lady's father's sister 
has also been cured by me of 
eczema, and her brother is now 
under my care for very severe 
eczema. 



194 Diseases of 

There is a tragic circumstance 
connected with my professional re- 
lationship with this socially impor- 
tant family, and it is this : Fifteen 
years ago I was treating a wee 
child of another branch of this 
family also for eczema that ex- 
tended to the greater part of the 
poor mite's whole body. I ex- 
plained to the parents that I re- 
garded the eczema in question as 
of a very pronouncedly constitu- 
tional nature, and that it was this 
constitutional disease that caused 
the truly terrible eczematous ooze, 
the skin being merely the medium 
of relief of the organism. Hence I 
gave my opinion that it would be 
dangerous to use local applications 
to the skin, lest the relatively fair 



the Skin. 195 



general state of the patient should 
be impaired ; nearly all the glands 
were enlarged, and primarily so, 
and not merely from cutaneous 
irritation, to which conclusion I 
came from finding such hyper- 
trophied or indurated glands in 
parts where there was no active 
eczema. 

What I am trying to say just 
amounts to this: My treatment was 
given up in contempt because I 
would not give any ointment or 
wash whatever, and the services 
of an eminent dermatologist were 
secured. Things went on very 
smoothly for a very few weeks, 
but the patient not long afterwards 
died "of weakness and exhaustion." 

In my judgment she died of the 



196 Diseases of 

practical application of the derma- 
tologist's gross ignorance of derma- 
tology : bedanbing and besmearing 
the skin with medicinal substances 
was the work of this probably well- 
meaning medical man ; but oh ! the 
shallow, shallow work ! 

Acute Uni vers al Erythema and 
Chronic Rheumatoid Arthritis. 

A maiden lady, 56 years of age, 
came to consult me on October 16, 
1890, for pretty severe rheumatoid 
arthritis of three years' standing, 
affecting hands, feet, elbows, and 
knees. Although fifty-six years of 
age her menses are regular. She has 
just returned from Buxton, which, 
she thinks, did her a little good. 
Her hands are swelled a good deal, 



the Skin. 197 



so that they are not of much use 
to her. She lias strumous scars in 
her neck. The pains are described 
as worst when she starts off, and 
worse in the evening, and worse on 
the East Coast than in London. 
Patient had been vaccinated three 
times. Bacillinum C. was given 
for a month. 

November 25, 1890. — The im- 
provement is very great indeed, — 
in fact, quite startling, for all the 
pain has gone and the swelling has 
sensibly diminished ; feet better ; 
can stand better ; and, moreover, 
she sleeps so much better. 

To continue the same medicine. 

December 5. — Patient hurries to 
me to show me the dreadful state of 
her skin, which is covered all over 
14 



198 Diseases of 

with acute erythema, rather papu- 
lar. She describes the irritation 
as terrible in the heat .... and 
.... the rheumatism had gone. 

January 1, 1891. — With very 
great difficulty I prevented this lady 
from putting something on " to 
cure " the erythema ; in fact, I did 
not quite succeed, and the case that 
seemed perfectly cured is not quite 
cured really, as the hands are stiff 
again and somewhat swelled. 

J$ Thuja occidentalis 30. 

February 19, 1891. — The hands 
are not so well. 

J$ Psor. 30, and a month later 
Bacill. C. finished the cure. 

The point of greatest interest to 
me in this narration is the vicarious 
erythema. 



the Skin. 199 

I saw a middle-aged lady yester- 
day whose hands are swelled and 
much disfigured lyy rheumatoid 
arthritis. The lady's sister tells 
me that the late Sir Erasmus Wil- 
son once cured the lady of eczema ; 
and we know well what the great 
Erasmus's " cures" were. 

Rhinophyma. 

Genuine severe rhynophyma is 
not a common disease. One case 
was under me last year, but patient 
only came two or three times ; the 
last time I saw him, both he and I 
were satisfied that the nose was 
somewhat smaller. Cases that 
stand, so to speak, midway between 
nasal dermatitis and rhinophyma 
are not so rare ; I cured two such 



200 Diseases of 

cases in 189 1, and both with our 
common antisycotics, principally 
Thuja, Sabina and Cupressus, all 
used in dynamic dose, and no local 
application whatever. 

Eczema in a Child of Three. 

On May 10th, 1888, a lady 
brought her three-year-old little 
boy to me to be treated for eczema 
in the bends of the knees ; these 
regions were pretty badly affected, 
and the little man's cervical glands 
were considerably enlarged. As 
the eczema was most trying in the 
warmth of the bed, I gave Sypk. 
CC. in very infrequent doses for a 
month. 

June 7. — Much better, notably 
of the glands, but the eruption still 



the Skin. 201 



itches in the warmth. Acidiim 
uricum 6, 5ij., three drops in water 
night and morning. 

Augusts. — Nearly well. Acidiim 
hippuricum, the same as the pre- 
vious prescription. 

This finished the cure. 

Case of Eczema Glandis of Six 
Years' Duration. 

An unmarried rufous gentleman, 
32 years of age, came under my 
observation on May 18, 1887, f° r 
left-sided varicocele and eczema of 
the glans and of the sulcus of the 
penis ; the eruption had been there 
for six years. Patient was paceau. 
He informed me that he had 
formerly had eczema on his head. 
I first gave him Clematis erecta x* } 



202 Diseases of 



five drops in water twice a day, but 
with no benefit. In June and July, 
for about five weeks lie was under 
Malandrinum 30, with very great 
amelioration ; and thereafter, for 
about the same length of time, he 
had from me Melitagrinum C. 

This cured the eczema, and pa- 
tient ceased attending. At the end 
of the year patient said there was a 
very little of the eczema still in 
the sulcus, but he did not think it 
worth while being treated for it. 

Case of Eczema. 

A married lady, 30 years of age, 
mother of two children, was brought 
to me by her husband on December 
4, 1 89 1, with pretty severe eczema 
that had been bad during the past 



the Skin. 203 



eight months, and being specially 
bad in the bends of arms and on 
the face, and worst of all aronnd 
the month ; most distressing of 
an evening. Her lips are dry, 
cracked, u for ever peeling." Pa- 
tient's condition was so bad, her 
general state so debilitated, her 
appearance so old, w-orn, and weary, 
that I felt it to be imperative to 
better her blood life and pnll her 
together, so to speak, before setting 
abont a scientific cnre of the case, 
so I pnt her on Levico for a 
few weeks, and then npon Bellis 
pere?inis for a month, when pa- 
tient wonld not come any more, 
even to please her hnsband, remark- 
ing, " Oh ! I'm getting on nicely 
now ; I do not want the doctor." 



204 Diseases of 



Case of Ringworm, Eczema, 
Acne, and Asthma. 

A powerful, somewat asthmatic 
gentleman, 58 years of age, came 
from the north to consult me on 
the 1 2th August 1891, telling me a 
history of slight winter asthma for 
many years ; this he keeps down 
with Turkish baths, which he has 
taken regularly ever since he was 
21 years of age. His appearance 
on being undressed was as if he 
had small-pox of moderate severity, 
only the pustules are those of acne. 
He tells me he had il three ring- 
worms across the belly " in the 
month of February 1881, which he 
got cured with ointments; and then 
he got eczema, and got this also 



the Skin. 205 



cured with ointments ; and then 
came this pustular eruption which 
ointments will not cure. 

Ijk B acill. 1000. 

August 26. — Much better. 

Rep. 

September 8. — " Those powders 
are too much for me ; they cause 
me bad breathing and sickly feel- 
ing ; worse in the morning ; the 
skin is rather better ; there is no 
matter in it now." 

He is much afraid of the pow- 
ders, " they act so powerfully." 

October 2. — The skin is clean- 
ing. 

fyXep.(CC) 

October 16. — Much better. 

ty Rep. (C.) 

October 30. — The chronic diffi- 



206 Diseases of 

culty of breathing (the asthma) has 
gone, the breathing being now 
normal. 

The same remedy was repeated 
a few times, and Thuja 30 was 
interpolated, when patient was 
well, and went abroad to divert his 
mind from grief dne to the death 
of his wife. 

The last time I saw him his 
exclamation was, " I am so much 
better in myself, — infinitely better 
in every way." 

Brawny Dermatitis. 

An elderly gentleman consulted 
me on Nov. 12, 1890, for an erup- 
tion of the skin, that I can only call 
brawny dermatitis. It was all over 
his body, and had been there for 



the Skin. 207 



years, and itched a great deal. 
This gentleman was discharged 
cured in less than a year, and still 
continues well. The remedies I 
used were Persicaria urens 30 and 
3, Urtica urens 0, and Sodium 
salicylate. 

Patient formerly suffered from 
chronic rheumatism, but ceased to 
do so after this rash came out. 

Now he has neither skin disease 
nor rheumatism. 

Very Severe Case of Sycosis. 

On September 26, 1890, a Lon- 
don professional man, 41 years of 
age, married, and in fair general 
health, came to me as a dernier 
ressort, and on the earnest solicita- 
tion of a friend and neighbour. 



2o8 Diseases of 

Said he : "I have always ridiculed 
homoeopathy, and do not believe in 
it the least little bit, but I am in 
despair; I have had this beastly 
skin disease for twelve years (point- 
ing to his chin and face), and I 
have been under treatment all the 
time by the most eminent surgeons 
of London ; altogether I have been 
under eleven different doctors,— of 
course all allopaths. " 

Patient's chin and face, co-exten- 
sive with his beard, was a " mass of 
corruption/' — i. e., dried up, caked 
together mattery ooze, which he 
was obliged to get off very frequently 
with the aid of a poultice, when the 
surface was red and angry and shiny, 
the sticky stuff at once beginning to 
appear again. An ointment he uses 



the Skin, 209 



keeps it down pretty well in the 
summer months, but is powerless 
from autumn to spring. He has 
also very severe pyorrhoea alveo- 
laris ; his gums have receded, and 
the bulk of his very beautifully 
formed teeth have already fallen out 
entire, or stand out from the gums 
ready to fall out ; his breath is ster- 
coraceous, and his gums and mouth 
generally he describes as " rotten." 
He has had recurrent ophthalmia 
many times. He tells me he has 
used scores of ointments, and been 
very severely handled by the skin 
specialists, having undergone scari- 
fications and epilations at many dif- 
ferent times. Patient has been twice 
vaccinated. The feeling in the dis- 
eased part he describes as stinging. 



2iO Diseases of 

My treatment was continued till 
June io, 1892, when I was able to 
declare him, as he declared himself, 
well* Treatment extending over all 
these months necessarily comprises 
a number of remedies, the case being 
so severe and of such long standing. 
Practically patient had all the lead- 
ing nosodic and other antisycotics, 
as well as Zincum acet. 1, Jequirity 
3*, Levico # (the strong water), 
Chelidon., majus #, and Calc. sulph. 

Note on Levico. 
The waters of Levico are a very 
favourite remedy of mine in many 
skin affections where I need a little 
tonic, and where it seems of great 
advantage to give the organism a 
rest from the effects of high dilu- 

*July 1893. — Continues quite well. 



the Skin. 211 



tions of the more specifically act- 
ing remedies. 

In very difficult and pathologi- 
cally complicated cases the organ- 
ism, under the influence of very high 
dilutions, appears to get excited and 
into a state of unrest; here progress 
seems suspended, and one then 
needs , figuratively s pe aking, a harm- 
less material — something to clean 
the slate and so get a fresh start : 
this the strong water of Levico 
does beautifully. A capital way to 
administer it is to order ten drops 
in a wineglassful of warm water 
two or three times a day, by pre- 
ference immediately after meals. 

Offensive Perspirations — 
Periodical Headaches. 

An unmarried lady, 38 years 



212 Diseases of 



of age, came under my care on 
July ii, 1892, principally for 
headaches and offensive perspira- 
tions. Patient liad lived some 
years in India, where she had ague 
badly. The headache was really 
brow-ague at a spot over the right 
eye, very bad at 7 P. M , and re- 
curring every eleven days. The 
perspirations were described as 
sour, oniony, nettly. 

J$ Trit. 6 Nat. mur. Six grains 
three times a day. 

Angus tg. — The powders brought 
back the ague, of which patient 
had long been free ! Thereupon she 
immediately took quinine. Per- 
spiration less offensive. 

1$} Nat. mur. 30. 

September 12. — Quite free from 



the Skin. 213 



headaches, and the perspiration 
has ceased to be offensive. The 
cure had held good when I last saw 
patient in February 1893. 

Lichen Urticarius. 

A bonny boy, 2^ years of age, 
was brought by his mother to me on 
the 7th of August 1890 for lichen 
urticarius. But there was an even 
more distressing feature in this 
case, for this mite of a boy was al- 
ready an inveterate masturbator. 
The urticarious spots were usually 
at their worst when he got warm in 
bed, or hot at any time. He had 
seatworms, picking his nose a good 
deal. He was about a year under my 
treatment, and was then discharged 
quite cured, not only of his cuta- 
15 



214 Diseases of 

neous affection, but also of his nose- 
picking and of his secret habit of 
mauling himself about ; for it was 
noteworthy that while he would 
pick his nose freely enough before 
folks, and even notwithstanding 
their forbidding it, he did not mas- 
turbate other than in secret. 

The remedy that cured the skin 
affection was very evidently Baczl- 
Iznum C. during one month at the 
beginning of the cure, and the 
same remedy in the two-hundredth 
dilution later on. The remedy that, 
cured his secret habit was very 
clearly Platina 30, under which he 
was during three separate (not con- 
secutive) months. There were inter- 
current ailings — cough, cold, an- 
orexia — and Thuja 30, Ipec. 1, 



the Skin. 215 



Ledum 3*, and Med. CC. respec- 
tively came into play. The precise 
parts played by these other fonr 
remedies in this case I could not 
quite determine. More particularly, 
I do not know which cured the seat- 
worms. But, as before stated, I am 
very sure the lichen was cured by 
the BacilL, and the masturbation 
was cured by the Platina 30. 

[On the subject of Platina in this 
regard, see Grauvogl's Lehrbuch.~] 

Remarks on the Origin of Self- 
Abuse In Children. 

The case of lichen urticarius just 
related teaches a lesson which 
physicians and parents might with 
advantage remember. We are far 



216 Diseases of 

too apt to suppose that vice and 
vicious habits are due to abstract sin 
trickling down upon us from the 
dim and distant past, or as simply 
generated, as it were, afresh by in- 
nate sinfulness. Well, in this we err 
egregiously. The best way to get 
at the core of a nebulous subject is 
to take concrete cases separately, 
from the very simplest standpoint. 
So let us take this simple case of 
nettle-rash. What was the nature of 
the lichen ? Waa it morally sinful? 
Clearly it was simply physical 
disease, and in this case probably 
from the boy's father. Was the 
nose-picking a sinful habit? or due 
to physical disease? By common 
consent nose-picking indicates gas- 
tric irritation, and most frequently 



the Skin. 217 



worms gets the blame. This boy 
had worms. 

We do not reckon his lichen or 
his worms unto him as sin, but 
recognize their simple morbid 
basis, and use remedies to cure 
them. 

So I do with masturbation gener- 
ally ; so I did with this boy's secret 
habit, that, left uncured, would most 
probably have resulted in his be- 
coming both physically and morally 
a wreck. But not only was the 
secret habit in this child completely 
cured, but he, in the words of his 
mother, "does not like to do so," — 
z. e., his sweeter {healthy) moral 
self shrinks from the very idea. 

Have the schools any therapeusis 
to compare to this ? I suppose a 



218 Diseases of 

soothing lotion or ointment for the 
child's moral nature. 

Eczema of Ears of Seven Years' 
Standing. 

On August 20, 1887, a little girl 
of nine was brought to me for an 
ill-smelling discharge from the 
ears, that was said to have started 
after she had had dysentery seven 
years previously. In the fold of the 
left arm a little eczema. Although 
only nine years old the child had 
been twice vaccinated, and was 
clearly quite blighted thereby. 

After being under treatment by 
Thuja occidentalis 30 for a month, 
my note runs, " Vast improvement 
all round." 

After a few weeks respectively of 



the Skin. 219 

Sabina 30 and Sulphur 30, patient 
left cured at the end of the year 1887. 

Flat Papilloma in the Anal 
Region. 

A childless married lady, a little 
over 30 years of age, came under my 
observation on July 19, 1887, for 
certain very distressing symptoms 
in the anal region, preventing sleep 
at night : worse at 2 A. M. On 
examining the parts I found the 
anal opening surrounded byhaemor- 
rhoidal buttons, and on the tip of 
one of these a flat papilloma about 
the size of a split horse-bean. By 
day the whole region was exceed- 
ingly uncomfortable only, but by 
night its soreness prevented sleep. 

fy Syp. CC. 



220 Diseases of 

August 1 6. — Very much better 
indeed ; sleeps now quite well. 
An examination sliows that the 
papilloma has quite disappeared. 

Patient remained another couple 
of weeks under my treatment for 
the haemorrhoids. These quite dis- 
appeared during that period under 
the influence of, first, Spiritus 
glandium quercus #, and then of 
Euphorbia amygdaloides. 

Pruritus Ani. 

A general staff-officer, no longer 
young, came under my care on 
Dec. ii, 1 89 1, complaining bitterly 
of being roused up at night with 
fearful itching at the anus. An 
examination of the part showed 
only the very slightest degree of 



the Skin. 221 



eczema. Being of opinion that the 
pruritus was due to port wine, I 
ordered Spiritns glandium quercus, 
ten drops in water night and 
morning. This cured the pruritus. 
When I next saw the general he 
said, " That's all right; now I want 
something for my bronchitis." 
The complaint was chronic winter 
catarrh of the bronchial lining. 
The Acetum Lobelicz, in four-drop 
doses every four hours, quite cured 
this in about three weeks. 

Case of Bat's Wing Disease — 
Lupus. 

A maiden lady, 48 years of age, 
from Shropshire, came on August 
5th, 1892, to consult me for an erup- 
tion on her nose and two cheeks, 



222 Diseases of 

the figure thus produced being 
responsible for the designation of 
bat's-wing disease. The eruption 
is getting very, very slowly worse 
for the past twelve years. The skin 
peels off in little flakes, leaving the 
underlying skin red, and this again 
dries and in its turn peels off, but 
very, very slowly and the whole of 
the skin is not involved,there being 
healthy skin between. Patient's 
father is stated to have died of 
decline at 57 years of age, and her 
mother, patient tells me, died at 52 
of mesenteric atrophy. One of 
patient's brothers died of phthisis, 
and her other six brothers all died in 
infancy. Her three sisters are alive. 
Patient has had active treatment, 
principally Arsenic and Mercury. 



the Skin. 223 



Ik Bacill. CC. 

September 2. — The bat's wing is 
half gone ! 

B? Rep. 

Sept. 30. — Nose quite free, ex- 
cept in the right side near the eye, 
where it is more active. 

Patient informs me that she has 
been three times vaccinated. 

]$> Thuja 30. 

Nov. "4. — There is just one 
small spot of the eruption left, 
near the corner of the eye. A 
good deal of haemorrhage from the 
rectum. 

I£> Bacill. CC. 

December 9. — Patient writes me 
under this date from her home : 
" I have no trace of the disease left ) 
but the piles have bled on four oc- 



224 Diseases of 

casions. I was so well while tak- 
ing the powder." 

fy Rep, 

January 13, 1893. — The skin 
remains quite well. "I eat double." 

And four months later the lady's 
sister, in answer to my inquiry, 
informed me that patient continued 
perfectly well. 

Papular Rash. * 

An unmarried lady, 23 years of 
age, was brought to me by her 
elder sister on Dec. 15, 1890, for 
a very disagreeable rash on the 
body. The patient had had measles, 
whooping-cough, chicken-pox, and 
jaundice during the course of her 
little life, and had also been twice 
vaccinated. Her menses were 



the Skin. 225 



irregular ; she suffered from nose- 
bleed. The eruption occupied the 
skin over the chest, stomach, 
and duodenum, and itched a good 
deal on going to bed. Patient is 
very costive, ansemic, and complains 
pretty eloquently of flatulent dys- 
pepsia. Her spleen is enlarged ; 
she twitches and jumps (starts) a 
good deal; is better in the evening, 
worse in the morning. 

Ijfc Thuja occidentalis 30, in infre- 
quent doses. 

In two months patient had gained 
five pounds in weight and was quite 
well, barring an enlarged spleen 
and little spells of nose-bleed. 
This was cured in a few weeks by 
Urtica urens 0, ten drops in water 
at bedtime, and the young lady has 



226 Diseases of 

continued to thrive ever since, so 
her mother told me quite lately. 

I have often maintained the 
reality of vaccinosis as a morbid 
entity, and as the years roll round 
I become more and more certain of 
my thesis. See my little treatise 
" On Vaccinosis." 

Epidemic Eczema. 

The only epidemic of eczema, 
apparently contagious, within my 
experience was one that broke out 
in the spring of 189 1 at a very 
large public school near London. 

The news came to me thus : — 
March 16, 1891. 

" Dear Sir. — On or about the 
5th of this month a spot appeared 
over the eyebrow of the bearer (my 



the Skin. 227 



son) . Thinking it merely a bruise 
received the previous day whilst 
playing football, a piece of gum 
paper was put over the place. 

u A few days served to show that 
the thing was more than a simple 
bruise, so we sent him over to Dr. 

, of ; he also thought it 

merely an unhealthy wound, ordered 
on a bread poultice, and gave some 
ointment to be applied when ' the 
wound ' was cleaned. At the end 
of two days I felt sure the diagnosis 
had been wrong, and so sent the 
boy over again to the doctor. It 
was then pronounced to be eczema. 

" Rhus tox. inwardly, and zinc 
ointment externally, were prescrib- 
ed, and a fish, fruit, and vegetable 
diet insisted upon. 



228 Diseases of the Skin. 

" This morning the thing has 
assnmed such alarming proportions 
that my husband and I felt we must 
have your advice regarding it. 

" Three of the boys playing in 
his team have broken out with the 
same kind of eruption." 

There were quite a nnmber of 
cases besides these, patient's 
brother being one of them. 

The eruption itched very much 
in the evening, and had spread a 
good deal when the lad called upon 
me with the just-cited letter of his 
mother. 

The iodide of sulphur in the third 
trituration, and six-grain doses fre- 
quently repeated, cured the eczema 
in both lads in about six weeks, and 
there has not been any return of it. 



PART III 



THE CONSTITUTIONAL CURE 
OF ALOPECIA AREATA. 

The Direct Art Cure of SPOT- 
BALDNESS, OR ALOPECIA Are- 
ata, by Internal Medication. 

gARRING a certain number of 
homoeopathic physicians, the 
universal treatmentof spot-baldness 
is by local measures, and one never 
hears of any constitutional cure. 
And yet such a state of one's scalp 
can hardly be health. Jonathan 
Hutchinson, who has vast experi- 
ence, says : "The entire absence of 
16 



230 Diseases of 

any form of ill-health in the sub- 
jects of alopecia areata induces me 
to put wholly aside any inquiry on 
that score (z\ e mJ ill-health)." 

Hutchinson also believes that 
pityriasis versicolor " is transmut- 
able with ringworm." We thus have 
three name-having ailments, viz. — 
ringworm, pityriasis versicolor, and 
alopecia areata, that are not accom- 
panied by any ill-health at all; such 
are the views held, but they are not 
mine, inasmuch as I am unable to 
believe such things, and my experi- 
ence contradicts them. 

Of ringworm, I have already 
treated in a separate (already re- 
ferred to) Monograph; with alopecia 
areata we are here concerned. I 
have examined a goodly number of 



the Shin. 231 



cases of ringworm, and never yet 
found a really healthy individual 
suffering therefrom: certainly they 
were not ill in bed or ill in them- 
selves at the time, but a constitu- 
tional taint I could discover in al- 
most every case, t. e., a phthisical 
taint, near or remote. 

I find the same taint in alopecia 
areata, but often another taint also. 
A word or two on the function of 
the hair may not be amiss. 

Exner has published, in a recent 
number of the Wiener Klinische 
Wochenschrzft, an article on this 
interesting subject. He states at 
the outset that the disposition of the 
hair on the different parts of the 
body always serves a definite object. 
The study of the descent of man 



232 Diseases of 

and of embryology has shown 
that our ancestors were entirely 
covered with hair, as are the an- 
thropoid apes. According to Dar- 
win, the gradual disappearance of 
the hair is due to the repulsion 
felt by women for hairy men, and 
their liking for the opposite ; that 
is, to sexual selection. In the same 
manner he explains the exagger- 
ated development of the hairy scalp 
in women, and of the beard in men, 
for in women the long hair and in 
men the beard have always been 
considered as attributes of beauty. 
As to the physiologic functions 
of hajrs, it is admitted that they are 
modified sense-organs, which have 
lost some of their connections with 
the nerves. It is probable that in 



the Skin. 233 

primitive man the distribution of 
the hair upon the bod}' was irregu- 
lar, and that the length, colour, 
structure and thickness of the hair 
varied with functions for which it 
was intended. The hair which has 
been left upon the body in the pro- 
cess of evolution has been left there 
for a definite purpose. Certain 
hairs serve as organs of touch, 
notably the eyelashes, the bulbs of 
which are surrounded by a network 
of nerve fibres, and in a less degree 
the hairs of the eyebrows. Both 
these serve to protect the eyes ; for 
being sensitive, the}' give warning 
of danger, so that reflex closure of 
the lids is produced. The eye- 
brows also prevent drops of sweat 
from running into the eyes, while 



234 Diseases of 

the eyelashes keep out dust. The 
eyebrows and lashes also serve a 
purpose in sexual selection. The 
down which covers the body is also 
endowed with tactile sense ; the 
hair in the region of the genitals 
and anus being the least sensitive. 
A thick growth of hair is also found 
in those parts of the body where 
friction must take place between 
contiguous cutaneous surfaces, as 
in the axillae, groin, perineo-scrotal 
and perineo-vulvar regions. By 
experiment with pieces of skin 
covered with hair, Bxner has shown 
that the hairy covering markedly 
diminishes the friction of the cuta- 
neous surfaces. 

In animals the hair serves to 
maintain and regulate the heat of 



the Skin. 235 



the body, but in man the hair of the 
scalp alone serves this purpose. 
Hair is itself a poor conductor of 
heat, and retains air, also a poor 
conductor in its interstices. 

The fact that the forehead is not 
covered with hair, Exner explains 
on the theory that in the contest be- 
tween the natural tendency of the 
hair to protect the head against 
changes of temperature and the 
tendency of human nature towards 
beauty, the latter has prevailed 
more easily because the non-con- 
ducting properties of that portion 
of the skull are increased by the 
air containing frontal sinuses, and 
that that portion of the head is eas- 
ily protected from theheat of the sun 
by inclining the head forward. 



236 Diseases of 



What is the nature of Alo- 
pecia Areata ? 

Inasmuch as opinions are so 
much divided on the true nature 
of this peculiarly interesting affec- 
tion, I have thought that it might 
be settled clinically. 

Is it related to ringworm, or not ? 

Now ringworm is very obviously 
accompanied by fungi — always, 
they say. Nobody can find any 
fungi in alopecia areata, still they 
may be present for all that, though 
they have not been found. 

Is Alopecia Areata catching ? 

The question, according to 
Hutchinson, must be answered in 
the affirmative; according to Alder 



the Skin. 237 



Smith, on the other hand, it nmst 
be answered in the negative — the 
former is a high authority, but so 
is the latter. Hutchinson even 
explains its favourite habitat at 
the back of the head, as due to the 
infection coming from the backs 
of chairs and from cushions. 

Both Hutchinson and Alder 
Smith are original observers, and 
form their opinions on the facts 
given by their own observations. 
My own experience goes to show 
that alopecia areata is not catching 
— that is, I have never been able 
to trace a case of such alopecia 
either from or to another person. 

Now what clinical evidence have 
I which goes to show that alopecia 
areata can be cured by the internal 



238 Diseases of 

administration of remedies ? and, 
this given, how does the same shed 
light upon the nature of the cases? 
Let me begin with a brief narration 
of a ease which, seen in the light 
of much previous experience as to 
phthisis, ringworm, and vaccinosis, 
indicates its double nature : — 

Alopecia Areata. 

A married gentleman, 34 years of 
age, came under my observation in 
the month of April 1894 ; circular 
baldness in patches here and there, 
also both ends of moustache are 
gone; much indigestion and phlegm 
for many years, and these symptoms 
led me to prescribe Thuja 30 ; and 
when he returned after a month of 
this remedy he complained of the 



the Skin. 239 



violent action of the Thuja 30. 
"Those powders have so upset me 
that I have had to keep my bed." 

No medicine. 

July 17. — Mending very beauti- 
fully, but quite lately the hair is 
falling out again very badly. 

No medicine. 

Aug. 20. — Jfy Bacill. 30. 

Oct. 23.- Hair growing every- 
where very well. 

J&Rep. 

He called a year later with ca- 
tarrhal symptoms of chest. 

fy Rep. 

And twice subsequently the same 
remedy was repeated. Discharged 
quite cured in the fall of 1896. 



240 Diseases of 



Alopecia Areata in a Lady of 
35 Years of Age. 

A married lady, 35 years of age, 
mother of three children, was 
brought by her husband to see me 
in the spring of 1897, for certain 
nerve symptoms, and, . • . u I have 
a bald patch on my head, about the 
size of a shilling, also two small 
wens on the left side of my head, 
in the hair." 

April 1 . — Bacill. 30. 

March 4. — Wens gone; urine 
very thick. Tub. test. C. 

June 1. — " I am much better ; 
the scurf in my hair is very trou- 
blesome, but I believe the hair is 
growing on the little bald patch 
which I showed you." 



the Skin. 241 



June 29. — Not quite so well ; 
very scurfy scalp. 

Jfy Tub. test. C. 
July 27. — BacilL C. 

We had here arrived at a point 
where further progress seemed 
barred. 

Aug. 26. — 5? Thuja occid. 30. 

Sept. 23. — " I have been to my 
hair-dresser's, and he tells me I 
have not nearly so much scurf on 
my head, and the bald patch is 
quite covered with hair." 

Loss of Moustache. 

A staff-officer, 59 years of age, 
came under my observation in 1894, 
first for debility, that remained after 
influenza. After being under Urtica 
ur. and Cypripedium pub. # for six 



242 Diseases of 

weeks, he was practically well; 
"but," said he, " look at the left side 
of my moustache ; the hair is all 
coming out, and in places the hair 
of my head. I can't sleep." 

April 2.- — Jfy Bad//. 30. 

June 11. — Some vomiting ; sleep 
less broken; the hair is visibly 
thicker, the roundish patch no 
longer so evidently circular. 

Aug. 15.- — Nearly well, mous- 
tache much thicker. 

Bfc Rep. 

Oct. 24, 1898. — Well; moustache 
flourishing. 

This case is interesting, because 
only one remedy was used all the 
time (infrequent doses), and the 
influence of this upon the hair- 



the Skin. 243 



growth was quite evident. At the 
beginning of the treatment the 
moustache had almost gone on the 
left side, and at about the centre of 
this left side it was practically 
hairless, and even on the right side 
the erstwhile well-grown moustache 
was indeed a sorry thing. It is 
more than two years since patient 
was discharged cured, and the cure 
holds good to date. Said I the 
other day to his daughter, " How's 
your father's moustache?" 

" Oh, it's all right ; as good as 
ever, but much more grey ; poor 
dear papa, he was in a way about 
his moustache." 

Case of Alopecia Areata. 
A very tall lad, fifteen years of 



244 Diseases of 



age, came under my observation in 
March 1893, to be treated for alo- 
pecia areata of moderate severity. 
" Large bald patches." There were 
scars in the right side of the neck, 
where glands had seemingly been 
excised ; some not very large indu- 
rated glands in both sides of the 
neck and in both groins. The young 
man's skin almost literally covered 
with severe acne. " A mass of pus- 
tules" is the note in my book — the 
patches had not the dry, clean, ivory- 
like surface we are accustomed to 
see in alopecia areata, but they were 
sticky and shiny, and he scratched 
them a good deal. This led me to 
Mai. C.j and a seemingly perfect 
cure resulted in three months. And 
eighteen months later a lady friend 



the Skin. 245 

of patient's family said to ine, 
" You made a wonderful cure of 
General X 's son's head." 

In April 1895 the y otLn g" man 
turned up again, but this time with 
only one bald patch over his left 
ear, " size of a crown piece." 

Ijfc Mai. C. 

May 2. — Patch smaller, and hair 
growing on it. — Rep. 

June 6. — No further progress. 

f*> BacilL 30. 

July 16. — Hair growing; neck- 
glands going down. — Rep. 

Sept.— Well. 

Two years later. His cousin in- 
forms me that the cure holds good. 

Alopecia Areata. 

The Countess X , set. 50, 

17 



246 Diseases of 

mother of a family, came under my 
observation for bald circular patches 
at the back of her head, that have 
been there only a short time she 
thinks, and for which she has been 
under eminent specialists, who say 
it is a nerve affection. Her lady- 
ship has a marvellous head of hair, 
particularly for one of her age, and 
hence it would seem almost more 
strange that she should have per- 
fectly bald circular patches in 
amongst such a mass of hair, 
strong and long reaching, a little 
armful in quantity, down to her 
hips. But so it was. 

Four or five months under 
Bacillinum resulted in a perfect 
cure ; the patches lost their shiny 
aspect and slowly covered with 



the Skin. 247 



little hairs, and in about six months 
it was impossible to find them. 
The cure holds good to date. 

Most of the cases of alopecia 
areata that have come under my 
care have been persons naturally 
blessed with uncommonly fine 
heads of hair. 

Severe Case. 

Lady X , married, childless, 4 1 

years of age,came under me in April 
1896. She wore a wig, and had 
numerous typical bald areas all 
over the scalp, and what little of 
the scalp was not affected by the 
alopecia, the hair thereon was 
cropped as stubble. She had tried 
so many things, and so many 
physicians, surgeons, and hair pro- 



248 Diseases of 



fessors, that she had quite given up 
all idea of ever being any better- 
had indeed become quite callous 
about it, and did not as a matter of 
fact consult me about her alopecia 
at all, but about recurrent cysts ; 
and it was only by accident that I 
discovered the alopecia one day 
when the wig was off, because of 
the great heat. 

The case concerns us here only 
for the alopecia areata, and as very 
many constitutional remedies were 
used, I am not able to say what 
remedies cured, but in less than a 
year, the alopecia was quite cured, 
and a year after beginning the 
treatment the wig could be entirely 
discarded, but the new hair was not 
yet long enough for her to dispense 



the Skin. 249 



with some artificial hair arrange- 
ment at the back. 

" All my life," she gave as the 
duration of her alopecia ; so a 
complete cure with remedies within 
a year is not bad. Thuja 30, 
BacilL 30, SuL 30, Psor. C. 
Hydrastis 0, and Urtica 0, were 
amongst the remedies used, and 
that they, or some of them, cured, 
admits of no doubt whatever, as no 
local application whatever was 
ordered by me, and the case had 
gone on for so many many years, 
in spite of the best and the worst 
treatment known in this London. 



INDEX. 



Abuse, self, in children, 215. 
Acne and boils, chronic crops of, 164. 
" and swelled neck, 128. 
" from cold drinks, 99. 
" of face and nose, and nasal derma- 
titis, 40. 
ringworm, and eczema, 204. 
Ague — scabies, 54. 

Alopecia areata, 174; its relation to ring- 
worm, 176 ; constitutional cure of, 
229 ; what is the nature of ? 236 ; not 
catching, 237 ; case of, in married 
gentleman, 34 years old, 238 ; in 
married lady, 35 years old, 240 ; in 
staff-officer, 59 years old, 241 ; in tall 
lad, 15 years old, 243 ; in Countess 
X — , 50 years old, 245 ; in Lady 
X — , married, 41 years old, 247. 



252 Index. 



Anal region, flat papilloma in the, 219. 

Angina pectoris from suppressed skin dis- 
ease, 1. 

Anglo-French School on lupus, 73. 

Ani, pruritus, 220. 

Anus, soft warts round the, 159. 

Arthritic urticaria, 142. 

Arthritis, chronic rheumatoid, and acute 
universal erythema, 196. 

Asthma, psoriasis, and enlarged liver, 7. 
specific enexant hematic, 5. 

Bacillinum C. in acne and swelled neck, 
129. 
CC. cures strumous eczema in 
a baby, 150. 
" in alopecia areata, 239, 240, 

241, 242, 245, 246, 249. 
Barium of very distinct advantage in ich- 
thyosis, 120. 
Bat's wing disease — lupus, 221. 
Bazaroff, Dr. Porfiry G., report by, on 
psoriasis, trachoma, and erysipelas, 
20. 



Index. 253 



Becker, Dr., on tetters, 51 ; on suppressed 

perspiration of feet, 52. 
Begbie, Dr. J. Warburton, on lupus, 89. 
Bellis perennis against the ill-effects of 
wet cold in the overheated, 100 ; cur- 
ative of complaints due to cold drinks 
when the body is heated, 104. 
Bernard, Dr. , on cases of skin diseases, 50. 
Besnier, M., on the connection between 

lupus and tuberculosis, 78. 
Betula alba, 120. 

Boils and acne, chronic crops of, 164. 
Bowen, Dr., of Boston, on epidemic alo- 
pecia, 186. 
Braw r ny dermatitis, 206. 
Burnett, Dr. J. C, on " Curability of Cat- 
aract with Medi- 
cines," 48. 
' * on ' ' Vaccinosis and 
its cure by Thuja, 
with Remarks 
on Homceopro- 
phylaxis," 31. 



254 Index. 



Cataract, Curability of, with Medicines, 
by Dr. J. C. Burnett, 48. 
double, from suppressed erup- 
tion, 11. 
Cataract — eruption on scalp, 27. 
" — ringworm of scalp, 46. 
" — scabies — furuncles, 49. 
Children, self-abuse in, 215. 
Chin and throat affections, 61. 

" hairless patches on, 37. 
Cold drinks, acne from, 99. 
Constipation, life-long, 123. 
Crusta lactea, 50. 
Cypripedium pub. in alopecia areata, 241. 

Daisy, the, its use in haemorrhage, dys- 
entery, and against the ill effects of 
wet cold in the overheated, 101. 

Darwin on hair in men and women, 232. 

Dermatitis, brawny, 206. 

1 ' habitual periodical facial , 1 04 . 

" nasal, 40. 

" vaccinal, 30. 



Index. 255 

Dublin Journal of Medical Science, 72. 
Dyspepsia — vomiting — neuralgia — neu- 
rasthenia — acute eczema, 145. 

Ear, external, eczema of, 192. 
Ears, eczema of, of seven years' stand- 
ing, 218. 
Eczema, acne, and ringworm, 204. 

acute — dyspepsia — vomiting — 
neuralgia — neurasthenia, 

145. 
capitis suppressed — fatal issue, 

10. 
case of, in married lady, 202. 
— enlarged ovary — chronic 

oophoritis, 69. 
" epidemic, 226. 

glandis of six years' duration, 

201. 
gouty, 155. 
hydrocephalus, latent vaccino- 

sis, 8. 
" in a child of three years old, 

200. 



256 Index, 



Eczema, inveterate, 153. 

of ears of seven years' stand- 
ing, 218. 
of external ear and meatus, 192. 
" ophthalmia, 12. 

severe case of sixteen years' 
standing — elephantiasis la- 
biorum vulvae — life-long 
constipation, 123. 
" strumous, in a baby, 150. 

suppressed, ossified heart from, 
14. 

Eczema, with internal metastatic symp- 
toms, 24. 

Enexanthematic asthma, 5. 

Eruption, pustular, 31, 33. 

Erysipelas, psoriasis, and trachoma, 20. 

Erythema, acute universal, and chronic 

rheumatoid arthritis, 196. 

" nasal, 160. 

" Etiology," Fletcher's, 98. 

Ewald on lupus, 86. 

Exner on alopecia areata, 231, 234, 235. 



Index. 257 



Facial dermatitis, habitual periodical, 

104. 
Favus, case of generalized, 92. 
Feet, suppressed perspiration of, 52. 
Finger-nails, diseased, 43. 
Fletcher, acne from cold drinks, 100. 
Fletcher's " Etiology," 98. 
Fox, Dr. Tilbury, on lupus, 78. 
Furuncles — scabies — cataract, 49. 

Goullon, Dr., of Weimar, 48 
Gouty eczema, 155. 

Hair in animals, 234. 

" in men and women, 232. 

Headaches, periodical — offensive perspir- 
ations, 211. 

Heart, ossified, from suppressed eczema, 
14. 

Heath, Dr. Alfred, his preparation of 
erythrinus, 138. 

Herpes s. tinea tonsurans, 167. 

Homceoprophylaxis, remarks on, by Dr. 
Burnett, 31. 



258 index. 



Houghton, Dr. James, on lupus, 73. 
Hughes on alopecia areata, 175. 
Hutchinson, Jonathan, on lupus', 73, 78. 
4 ' " on alopecia are- 

ata, 176, 229. 
Hyde on lupus, 76. 
Hydrastis in alopecia areata, 249. 
Hydrocephalus, eczema, latent vaccino- 
sis, 8. 

Ichthyosis, case of, 117. 

Kaposi on generalized favus, 92. 

" on lupus, 74. 
Koch, Dr. Robert, on lupus, 80, 82. 
Kundrat, Professor, his autopsy of case 
of generalized favus, 93. 

Leigh, Dr. Richmond, on epidemic alo- 
pecia, 185. 
Levico, note on, 210. 
Lichen urticarius, 213. 
" urticatus, 157. 



Index. 259 



Liveing, Dr. , on the cause of alopecia, 1 79. 
Liver, enlarged, asthma, and psoriasis, 7. 
London Medical Record, report of case 

of generalized favus, 92. 
Lupus — bat's wing disease, 22 r. 
" clinical aspects of, 77. 

constitutional nature of, 71. 
" experimental, 83. 
" histological, 79. 

(tuberculoderma), 87. 

Mai. C in alopecia areata, 244, 245. 

Metastatic symptoms, internal, in eczema, 
24. 

Miliary tuberculosis, 87. 

Mindererus, in his Kriegs-Artzeney \ com- 
mends the daisy, 102. 

Moustache, loss of, in staff-officer, 241. 

Nasal dermatitis, 40. 
" erythema, 160. 

Neck, swelled, and acne, 128. 

Neisser on lupus, 76, 86. 

Neuralgia — neurasthenia — acute eczema 
— dyspepsia— vomiting, 145. 



260 Index. 



Oophoritis, chronic — eczema — enlarged 

ovary, 69. 
Ophthalmia, eczema, 12. 
Ossified heart from suppressed eczema, 

14. 
Ovary, enlarged — eczema — chronic 

oophoritis, 69. 

Pagenstecher, his inoculations from con- 
junctival lupus, 83. 

Papilloma, flat, in the anal region, 219. 

Papular rash, 224. 

Patch, the sternal, 56. 

Patches, hairless, on chin, 37. 

Perspirations, offensive — periodical head- 
aches, 211. 

Pityriasis rubra, 136. 

Platanus of very distinct advantage in 
ichthyosis, 120. 

Pruritus ani, 220. 

Psor. C. in alopecia areata, 249. 

Psoriasis and trachoma, disappearance of, 
after erysipelas, 20. 



Index. 261 



Psoriasis, asthma, and enlarged liver, 7. 
Pustular eruption, 31, 33. 

Rash, papular, 224. 

Record, London Medical, on disappear- 
ance of psoriasis and trachoma after 
erysipelas, 20. 
Rheumatoid arthritis, chronic, 196. 
Rhinophyma, 199. 
Ringworm, eczema, and acne, 204. 

(herpes s. tinea tonsurans), 
167. 
''Ringworm; Its Constitutional Nature 
and Cure," by Dr. J. 
Compton Burnett, 168. 
its relation to alopecia are- 
ata, 176. 
Ringworm, no healthy individual suffers 
from, 231. 
of scalp — cataract, 46. 

Sarcognomy, 60. 
Scabies — ague, 54. 
18 



262 Index. 



Scabies — cataract — furuncles, 49. 
Scalp, eruption on — cataract, 27. 
life-long eruption of , 162. 
ringworm of — cataract, 46. 
Schorer, Christoph, in his Medicina pere- 
grinantium, commends the daisy, 
103. 
Schroeder's, D. Johann, " Pharmacopoeia 
Universalis," commends the daisy, 
100, 103. 
Scrofuloderma, ulcerating, 87. 
Self-abuse in children, remarks on the 

origin of, 215. 
Sine ira et studio, 115. 
Skin affections, relationship of, to inter- 
nal organs, 66. 
" tuberculosis of the, 87. 
Smith, Alder, on alopecia areata, 178. 
" Prof. Dr. W. G. , on lupus, 72, 
88-92. 
Specialism, absurdity of, 63. 
Spot baldness, or alopecia areata, cure of, 
229. 



Index. 263 



Sternal patch, the, 56. 
Strumous eczema in a baby, 150, 
Sul. in alopecia areata, 249. 
Sycosis, very severe case of, 207. 

Tetters, as treated b}^ Dr. Becker, 51. 
Thomson, Dr. Todd, his treatment of 

lupus, 90. 
Throat and chin affections, 61. 
Thuja as used by Dr. Burnett for cure of 
vaccinosis, 3.1. 
in acne and swelled neck, 129. 
in alopecia areata, 238, 239, 241, 
249. 
Trachoma and psoriasis, disappearance 

of, after erysipelas, 20. 
Tub. test. C. in alopecia areata, 240, 241. 
Tuberculoderma (lupus), 87. 
Tuberculosis of the skin, 87. 
Tumours and the skin, 94. 

Urtica in alopecia areata, 241, 249. 
Urticaria, arthritic, 142. 



264 Index. 



Vaccinal dermatitis, 30. 
" Vaccinosis and its Cure by Thuja, with 
Remarks on Homceopro- 
phylaxis," by Dr. J. C. 
Burnett, 31. 
latent, hydrocephalus, eczema, 8. 
Veiel on lupus, 75. 
Vidal and Eeloir on lupus, 84. 
Vienna School on lupus, 74. 
Vomiting — neuralgia — neurasthenia — 

acute eczema — dyspepsia, 145. 
Vulva, ulcerative eruption of, 131. 
White, Dr. J. C, of Boston, on epidemic 

alopecia, 186. 
Wilson, Erasmus, his treatment of eczema, 
70, 199. 
" Erasmus, his treatment of sup- 
pressed skin disease, 3. 
Warts, crop of soft, round the anus, 159. 
Ziegler on lupus, 75, 79. 



